A 62-year-old man presented to the emergency department with a 3-month history of gradually growing shortness of breath, fatigue, anorexia, and weight loss. The patient underwent orthotopic heart transplantation for ischemic cardiomyopathy 26 months before. Medication history Triple therapy of cyclosporine, azathioprine, and prednisolone for immunosuppression Prednisolone at 1 mg/kg orally daily, which was tapered over three weeks to 20 mg daily and then continued for three months Prednisolone was decreased to 10 mg for the subsequent three months and finally reduced to 5 mg daily for the last six months Maintenance immunosuppression regimen contains cyclosporine and azathioprine.
The patient developed a one-month persistent non-productive cough and left thigh pain. Medical history Coronary artery bypass grafting for triple-vessel coronary artery disease (eight years before)…
