A unique case of rituximab-related posterior reversible encephalopathy syndrome in a heart transplant recipient with posttransplant lymphoproliferative disorder.

Rituximab is commonly used as a first line therapy to treat posttransplant lymphoproliferative disorders (PTLDs). It has also proved useful in the management of refractory antibody mediated graft rejection. We report an unusual case in which a heart transplant recipient being treated with rituximab for PTLD developed altered mental status, hallucinations and visual symptoms and magnetic resonance imaging (MRI) findings of symmetrical enhancement suggestive of posterior reversible leukoencephalopathy syndrome (PRES).

Concomitant Kaposi sarcoma and multicentric Castleman's disease in a heart transplant recipient.

Post-transplant human herpes virus -8 (HHV-8)/Kaposi sarcoma herpes virus (KSHV) infection is associated with neoplastic and non-neoplastic diseases. Kaposi sarcoma (KS), multicentric Castleman's disease (MCD), and primary effusion lymphomas (PEL) are the most common HHV-8-associated neoplastic complications described in solid organ transplant (SOT) patients. Concurrent KS and MCD have been previously described after transplantation only twice - once after liver transplantation and once after renal transplantation.

Cardiac transplantation and/or mechanical circulatory support device placement using heparin anti-coagulation in the presence of acute heparin-induced thrombocytopenia.

Background: Patients with congestive heart failure, decreased left ventricular function, and debilitation are frequently maintained on anti-coagulants, including heparin. As such, these patients are at high risk for developing heparin-induced thrombocytopenia (HIT). Some of these HIT-positive individuals will ultimately undergo urgent heart transplantation or placement of a mechanical circulatory support device (MCSD).

Therapeutic implications of T-cell clonopathy of unknown significance in chronic immune thrombocytopenic purpura.

Immune thrombocytopenic purpura (ITP) is typically considered an autoimmune disorder related to the production of autoantibodies; however, recent evidence indicates that cell-mediated cytotoxicity may be important pathogenetically in some cases. We describe seven patients with chronic ITP and concurrent T-cell clonopathy of unknown significance (TCUS), who failed various treatment regimens for ITP, including steroids, gamma globulins, splenectomy and rituximab, but had anecdotal success with azathioprine. These observations support the notion that ITP has heterogeneous biologic mechanisms, and that patients with persistent chronic ITP should be evaluated for T-cell clonality and considered for treatment options that are directed against cytotoxic T-cells.

A novel therapeutic approach to the treatment of scleroderma-associated pulmonary complications: safety and efficacy of combination therapy with imatinib and cyclophosphamide.

Objective: Scleroderma-related interstitial lung disease (SSc-ILD) has limited therapeutic options due to unclear pathogenesis. Recently, PDGF receptor (PDGFR) amplification has been postulated to cause fibrosis. We hypothesized that a combination of immunosuppressive agents, e.