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PULMONARY BLASTOMYCOSIS FOLLOWING ECULIZUMAB THERAPY IN A LUNG TRANSPLANT RECIPIENT

TAKASHİ HİRAMA, REX MİCHAEL SANTİAGO, ROHAN JOHN, CECİLİA CHAPARRO

Experimental and Clinical Transplantation - 2020;18(3):410-413

Division of Respirology, Department of Medicine, University of Toronto, Ontario, Canada

 

Objectives: Lung transplant recipients are at risk of developing many kinds of lung infection, such as community-acquired, nosocomial, opportunistic, and endemic. Here, we report a young lung transplant recipient who developed blastomycosis, which had most likely occurred following eculizumab treatment for atypical hemolytic uremia syndrome. We hypothesize that the agent interfering with C5 would influence the immune response against Blastomyces species. Although eculizumab has opened a new era for treatment of atypical hemolytic uremia syndrome and has led to the understanding that complementmediated pathology is needed, the risk of potentially fatal infections by blocking the complement pathway has not been fully elucidated. Careful follow-up and frequent tests to look for infections are needed after using this monoclonal antibody.