0
Postgraduate Education Corner: PULMONARY AND CRITICAL CARE PEARLS |

Persistent Dyspnea in a 59-Year-Old Woman Receiving Immunosuppressants

Subhraleena Das, MD; Sujith V. Cherian, MD; Nabamita Das, MD; Amarinder Singh Garcha, MD; Robert Lenox, MD, FCCP; James Sexton, MD, FCCP
Author and Funding Information

From the Department of Medicine (Drs S. Das, Cherian, N. Das, and Garcha) and Department of Pulmonary and Critical Care (Drs Lenox and Sexton), SUNY Upstate Medical University, Syracuse, NY.

Correspondence to: Subhraleena Das, MD, SUNY Upstate Medical University, 50 Presidential Plaza, Apt 211, Syracuse, NY 13202; e-mail: dass@upstate.edu


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2011 American College of Chest Physicians


Chest. 2011;140(3):818-822. doi:10.1378/chest.11-0061
Text Size: A A A
Published online

Extract

A 59-year-old woman was admitted to our institution with worsening shortness of breath and fatigue. Eight months earlier, she had received a living donor kidney transplant. She had been doing well on immunosuppressants, which were azathioprine, sirolimus, prednisone, and sulfamethoxazole-trimethoprim; sirolimus was started 2 months prior to her current admission. Two weeks before this presentation, the patient was admitted for similar complaints with fever, and her condition was diagnosed as pneumonia and urinary tract infection complicated by gram-negative bacteremia. Subsequently, she was given meropenem and discharged with a 21-day prescription. Two weeks later, she presented to the transplant clinic with worsening fatigue and shortness of breath and was admitted. The patient’s medical history was significant for hypertension, hyperlipidemia, and end-stage renal disease secondary to hemolytic uremic syndrome. She was a nonsmoker and denied a history of contact with sick persons, pets, or travel. There was no family history of malignancy.

First Page Preview

View Large
First page PDF preview

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

Suggested Readings

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543