RESUMEN
This case report highlights the use of ECT in an adolescent patient with a COVID-19 infection, which is an area of limited data. The patient received a full course of bitemporal ECT, with a total of 15 treatments administered over four months. The patient responded robustly, with a complete return to her pre-infection baseline mental status, and response has remained durable for one-year post continuation phase ECT taper. Maintenance ECT considerations for catatonia should be determined on a case-by-case basis but was not needed for our patient, given the durability of the response to ECT.
RESUMEN
Post-transplant lymphoproliferative disorder (PTLD) is a rare condition that occurs in patients who have undergone solid organ transplantation. Symptoms at presentation depend on the organs involved. PTLD most commonly occurs in the first year after transplant (early onset) or around 5 years after transplant (late onset). Herein, we report a rare presentation of central nervous system PTLD in an adult who presented with seizures 17 years after renal transplantation. After extensive infectious and transplant-related workup, brain biopsy confirmed the diagnosis of PTLD. The patient was treated with rituximab and high-dose methotrexate. Eighteen months later, the patient had no signs of recurrence. Very late-onset (>10 years) PTLD is rare, but is likely to become more common with more long-term survivors of solid organ transplant. Data are limited but show that the factors associated with very late-onset PTLD are different from early or late-onset PTLD.