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Old 12-20-2012
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Arrow A 32-year-old woman with right paranasal sinus mass

A 32-year-old woman develops a progressive idiopathic cardiomyopathy and eventually undergoes a cardiac transplant. She is placed on a rigorous protocol for immunosuppression. Two years later she develops right-sided sinus fullness, and imaging reveals a mass filling the right paranasal sinus. She is treated with a reduction in immunosuppression and acyclovir. She achieves a full recovery. Why is acyclovir part of her therapeutic regimen?

(A) Acyclovir has also been shown to have antineoplastic properties
(B) Acyclovir is necessary for prophylaxis against cytomegalovirus in any immunosuppressed patient
(C) Acyclovir will reduce the risk of infection due to radiation of the mucous membranes and subsequent breakdown
(D) Eradication of Epstein-Barr virus may contribute to resolution of the paranasal sinus mass
(E) Since the patientís immunosuppressive regimen must be decreased, protection against viruses that might infect the patientís new heart is particularly important
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(D) Eradication of Epstein-Barr virus may contribute to resolution of the paranasal sinus mass

http://www.ajnr.org/content/23/5/855.full

Last edited by aknz; 12-20-2012 at 11:20 AM.
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Quote:
Originally Posted by heartbeat View Post
A 32-year-old woman develops a progressive idiopathic cardiomyopathy and eventually undergoes a cardiac transplant. She is placed on a rigorous protocol for immunosuppression. Two years later she develops right-sided sinus fullness, and imaging reveals a mass filling the right paranasal sinus. She is treated with a reduction in immunosuppression and acyclovir. She achieves a full recovery. Why is acyclovir part of her therapeutic regimen?

(A) Acyclovir has also been shown to have antineoplastic properties
(B) Acyclovir is necessary for prophylaxis against cytomegalovirus in any immunosuppressed patient
(C) Acyclovir will reduce the risk of infection due to radiation of the mucous membranes and subsequent breakdown
(D) Eradication of Epstein-Barr virus may contribute to resolution of the paranasal sinus mass
(E) Since the patientís immunosuppressive regimen must be decreased, protection against viruses that might infect the patientís new heart is particularly important
After reading AKnz's article, i would go with D
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Old 12-21-2012
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d) treatment of EBV cures cancer
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Quote:
Originally Posted by heartbeat View Post
A 32-year-old woman develops a progressive idiopathic cardiomyopathy and eventually undergoes a cardiac transplant. She is placed on a rigorous protocol for immunosuppression. Two years later she develops right-sided sinus fullness, and imaging reveals a mass filling the right paranasal sinus. She is treated with a reduction in immunosuppression and acyclovir. She achieves a full recovery. Why is acyclovir part of her therapeutic regimen?

(A) Acyclovir has also been shown to have antineoplastic properties
(B) Acyclovir is necessary for prophylaxis against cytomegalovirus in any immunosuppressed patient
(C) Acyclovir will reduce the risk of infection due to radiation of the mucous membranes and subsequent breakdown
(D) Eradication of Epstein-Barr virus may contribute to resolution of the paranasal sinus mass
(E) Since the patientís immunosuppressive regimen must be decreased, protection against viruses that might infect the patientís new heart is particularly important
i think its C.
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Post-transplant lymphoproliferative disorder (PTLD)

Quote:
The disease is an uncontrolled proliferation of B cell lymphocytes following infection with Epstein-Barr virus.[1] Production of an interleukin-10, an endogenous anti-T cell cytokine, has also been implicated.
In immunocompetent patients, Epstein-Barr virus causes infectious mononucleosis, characterised by a proliferation of B-lymphocytes which is controlled by Suppressor T cells.
However, calcineurin inhibitors (tacrolimus and cyclosporine), used as immunosuppressants in organ transplantation inhibit T cell function, and can prevent the control of the B cell proliferation.

PTLD may spontaneously regress on reduction or cessation of immunosuppressant medication,[2] and can also be treated with addition of anti-viral therapy. In some cases it will progress to non-Hodgkin's lymphoma and may be fatal.
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Quote:
Originally Posted by Novobiocin View Post
Post-transplant lymphoproliferative disorder (PTLD)
Quote:
The disease is an uncontrolled proliferation of B cell lymphocytes following infection with Epstein-Barr virus.[1] Production of an interleukin-10, an endogenous anti-T cell cytokine, has also been implicated.
In immunocompetent patients, Epstein-Barr virus causes infectious mononucleosis, characterised by a proliferation of B-lymphocytes which is controlled by Suppressor T cells.
However, calcineurin inhibitors (tacrolimus and cyclosporine), used as immunosuppressants in organ transplantation inhibit T cell function, and can prevent the control of the B cell proliferation.

PTLD may spontaneously regress on reduction or cessation of immunosuppressant medication,[2] and can also be treated with addition of anti-viral therapy. In some cases it will progress to non-Hodgkin's lymphoma and may be fatal.
Yeah exactly so correct ans is (D)
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