Airway obstruction in an immunosuppressed child
C. M. Myer 3rd and J. S. Reilly
Recipients of organ transplants who require continuous immunosuppression
appear to have an increased incidence of lymphoproliferative disorders. A
case of severe upper airway obstruction resulted from adenotonsillar
hypertrophy in a 2-year-old girl following liver transplantation.
Tonsillectomy and adenoidectomy dramatically reversed the airway problem
and confirmed a transplant-associated lymphoproliferative disorder. A
generalized lymphadenopathy also regressed with reduction of cyclosporine
immunosuppression. We urge vigilance in monitoring transplant recipients,
particularly children, for problems of upper airway obstruction and
advocate prompt biopsy of persistently enlarged lymphoid tissue in all
immunosuppressed individuals who fail to respond to conventional medical
therapy.
