Case 35-1984 — Pulmonary Infiltrates 12 Years after Renal Transplantation

Presentation of CaseA 48-year-old immunosuppressed man was admitted to the hospital because of pneumonitis.He was well until 12 years earlier, when hematuria and hypertension developed suddenly. He entered another hospital; bilateral nephrectomy was performed, and a cadaveric renal transplant was inserted on the right side. He was told of a positive test for hepatitis B surface antibody and a negative test for antigen. Two bouts of acute rejection were treated with intravenously administered corticosteroids. A later episode of ureteral obstruction was treated by surgical repair. Hewas discharged on prednisone and azathioprine. Five years later podagra developed. Cyclophosphamide was . . .