Incidence Of Clinical Symptoms Research Articles

Determination of Incidence of Soft Tissue Reactions after Total Hip Replacement using Elastography and Role of Elastography in Screening of Periprosthetic Soft Tissue: A Prospective Observational Study

Introduction: Adverse local tissue reactions after Total Hip Replacement (THR) have been widely described in literature recently as a course of aseptic loosening. Evaluation for any adverse soft tissue reactions is challenging with traditional imaging techniques like Magnetic Resonance Imaging (MRI), and are limited, due to production of metallic artifact. Ultrasound, specifically its refined form elastography, has emerged recently as a useful tool for assessing the soft tissues. Aim: To determine the incidence of soft tissue reactions in cases of THR and to evaluate role of elastography in assessment of periprosthetic soft tissue. Materials and Methods: This prospective observational study was conducted in the Department of Orthopaedics, Dr. Hardas Singh Orthopaedic Hospital, Amritsar, Punjab, India, from May 2013 to April 2014. Study comprises of consecutively followedup 66 hips which were evaluated and assessed clinically and radiologically using ultrasound elastography for periprosthetic soft tissue and degree of fibrosis. The MRI was done in patients with positive findings only. Diagnosis was then confirmed with biopsy in patients who underwent revision surgery. Incidence of clinical symptoms, implant loosening, stability of implant, various types of soft tissue reactions, pseudotumour formation and synovial hypertrophy were determined and association between clinical and radiological findings was done. Chi-square test was determined to see the statistical significance. Results: Total of 66 hips were studied in 60 patients with mean age of 56.08±16.55 years (26-95 years). The incidence of soft tissue reactions observed in the study was 83.3% (n=55), of all 66 hips 36 were symptomatic, Implant loosening was seen in 29 hips, pseudotumours were detected in 3 (4.5%) hips, cystic nodules in 2 (3.0%) hips, enlarged lymph nodes in one (1.5%) hip, fibrogranuloma in 2 (3%) hips and synovial thickening was seen in 12 hips. Association of Harris Hip Score with capsular thickness, implant stability and acetabular loosening was found to be statistically significant. Conclusion: The study shows a substantially higher incidence of soft tissue reaction and capsular hypertrophy following THR. Ultrasound elastography is a good screening tool to detect early soft tissue changes in periprosthetic tissue.

Influence of Individualized Nursing Mode on the Incidence of Clinical Symptoms and Complications of Pneumonia in Children

Influence of Individualized Nursing Mode on the Incidence of Clinical Symptoms and Complications of Pneumonia in Children

Частота функціональних розладів і клінічних симптомів, що можуть бути пов’язані з лактазною недостатністю в дітей раннього віку м. Львова

На сьогодні порушення травної системи в дітей перших років життя залишаються актуальною проблемою практичної педіатрії та поширеною причиною звернень батьків до лікаря. Важливе значення в генезі розвитку функціональних порушень травної системи дітей цього віку може мати лактазна недостатність. В анкетно-опитувальне дослідження було включено 327 дітей із міста Львова. Метою дослідження була оцінка частоти клінічних симптомів, що можуть бути пов’язані з лактазною недостатністю в дітей першого року життя. Серед клінічних симптомів у дітей раннього віку, за даними анкетування, переважали зригування та коліки, розлади випорожнень. Діагноз лактазної недостатності був установлений у 3,4 % (11) дітей, приймали фермент лактазу 2,8 % (9) дітей.

Clinical manifestations, laboratory markers, and renal ultrasonographic examinations in 1-month to 12-year-old Iranian children with pyelonephritis: a six-year cross-sectional retrospective study

BackgroundUpper urinary tract infection (UTI) or pyelonephritis may increase the pathogenesis rate and risk of severe complications in children due to kidney atrophy.ObjectiveA set of clinical symptoms, laboratory markers, and ultrasound findings were assessed to achieve the early diagnosis and prognosis of pyelonephritis in hospitalized pediatrics.MethodsA cross-sectional study with 104 Iranian children (95 girls and 9 boys) aged 1 month to 12 years with acute pyelonephritis during 2012–2018 was conducted. The ultrasound examination of kidneys and urinary tract during hospitalization, the incidence of clinical symptoms, and laboratory markers in blood and urine were monitored to identify the best predictive factors of early diagnosis of this bacterial infection.ResultsThree-fourth of the patients had one of the four clinical symptoms of abdominal pain, constipation, dysuria, and vomiting, while others were asymptomatic. A much frequency of pyuria (88.46%), Escherichia coli in urine (92.31%), leukocytosis (81.73%), and high ESR (> 10 mm/h, 92.30%) and CRP (> 10 mg/L, 82.82%) was observed. The kidney and urinary tract ultrasonography only in 32.7% of children revealed findings in favor of pyelonephritis (cystitis, ureteral stones, and hydronephrosis).ConclusionThere was a high frequency of clinical signs and laboratory markers associated with pyelonephritis. Ultrasound alone was not an efficient tool to track febrile UTI as most patients presented normal sonography.

The role for pre-operative CT chest scans in suspected COVID-19 patients requiring emergent surgery

ABSTRACT Objective: To study the role for preoperative CT chest scans in suspected COVID-19 patients requiring emergent surgery. Design: Retrospective – observational. Participants: A total of 98 patients admitted for emergency surgery with COVID-19 infection and underwent preoperative CT chest scanning. Main outcome measurements: Incidence of clinical symptoms of COVID-19 infection upon presentation, imaging characteristics in chest CT and semi-quantitative CT severity score. Results: The median age of the study cohorts was 50 years (interquartile range (IQR): 40–60 years) and 52/98 (53.1%) were males. The most common symptoms were fever (80.6%) and cough (65.3%). 50/98 had positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RT-PCR test prior to CT scan, while 48/98 had positive reverse transcriptase-polymerase chain reaction (RT-PCR) result returned after imaging. The imaging characteristics were bilateral infiltrates on CT of 90/98, with 70/98 of infiltrates located peripherally and 28/98 located peripherally and centrally. The most common disease pattern was ground-glass opacities, observed in 95/98. The median total COVID-19 CT severity score was 7 (IQR: 4–14), corresponding to 5–25% global lung involvement. Conclusion: Patients with mild symptomatic COVID-19 in this study displayed CT evidence of SARS-CoV-2 infection. Preoperative CT imaging should be considered for identifying suspected active SARS-CoV-2 cases in resource limited environments with high community spread, to aid in resource allocation and personal protective equipment (PPE) rationing.

Clinical features of pulmonary cryptococcosis among patients with different levels of peripheral blood CD4+ T lymphocyte counts

BackgroundThe clinical manifestation of pulmonary cryptococcosis varies notably between immunocompromised and immunocompetent patients. To better understand pulmonary cryptococcosis, we compared the clinical features of pulmonary cryptococcosis patients with or without decreased peripheral blood CD4+ T cell counts.MethodsWe retrospectively reviewed the medical records of 80 patients with cryptococcosis who had been treated in Jingling Hospital from January 2011 to January 2016. According to the normal range of peripheral blood CD4 + T-lymphocyte counts in our population, we chose CD4 = 378/μL as a cut-off value.ResultsThe proportion of fever in the patients with decreased CD4+ T cells was higher than that of the patients with a normal amount of CD4+ T cells (86.7% vs 28.6%, P < 0.001). The incidence of clinical symptoms, such as cough (60.6% vs 64.7%, P = 0.729), chest pain (9.1% vs 26.5%, P = 0.064), and dyspnea (27.3% vs 23.5%, P = 0.725) showed no difference between patients with low CD4+ T cell counts and those with normal CD4+ T cell counts. The number of asymptomatic patients in the CD4+ T cell normal group was higher than that in the decreased CD4+ T cell group (17.1% vs 0%, P = 0.005). Nodules, masses, and halo signs were more common in the CD4+ T cell normal patients than in the low-CD4+ T cell patients (79.4% vs 54.5%, P = 0.03). The opposite trend was observed for cavitations (14.7% vs 51.5%, P = 0.001). The other CT findings, including pulmonary consolidation (P = 0.205), and pleural effusion (P = 0.641), did not differ significantly between the two groups.ConclusionsCD4+ T lymphocytes have a significant impact on the clinical and radiological characteristics of pulmonary cryptococcosis. The patients with normal CD4+ T cell counts were found to have less fever and more nodule-like radiographic findings.Trial registration2011NJKY-023-01. Registered on January 10, 2011.

Incidence of clinical symptoms and neurological signs in patients with chronic arsenic exposure in miyazaki, Japan: A 40-year retrospective descriptive study

Incidence of clinical symptoms and neurological signs in patients with chronic arsenic exposure in miyazaki, Japan: A 40-year retrospective descriptive study

Incidence of clinical symptoms during long-duration orbital spaceflight.

BackgroundThe environment of spaceflight may elevate an astronaut’s clinical risk for specific diseases. The purpose of this study was to derive, as accurately as currently possible, an assessment of in-flight clinical “incidence” data, based on observed clinical symptoms in astronauts on board the International Space Station (ISS).MethodsElectronic medical records were examined from 46 long-duration ISS crew members, each serving approximately a 6-month mission on board the ISS, constituting 20.57 total flight years. Incidence for immunological-related adverse health events or relevant clinical symptoms was tabulated in a non-identifiable fashion. Event categories included infectious diseases, allergies, and rashes/hypersensitivities. A subsequent re-evaluation of more notable events, either of prolonged duration or unresponsive to treatment, was performed.ResultsFor the disease/symptom categories used in this evaluation, the ISS incidence rate was 3.40 events per flight year. Skin rashes were the most reported event (1.12/flight year) followed by upper respiratory symptoms (0.97/flight year) and various other (non-respiratory) infectious processes. During flight, 46% of crew members reported an event deemed “notable”. Among the notable events, 40% were classified as rashes/hypersensitivities. Characterization of on-orbit rashes manifested as redness with irritation, and could present on a variety of body locations.ConclusionBased on reported symptoms, astronauts experience adverse medical events of varying severity during long-duration spaceflights. The data suggests caution, from both a vehicle design and biomedical countermeasures perspective, as space agencies plan for prolonged deep space exploration missions.

Cerebral-perfusion-based single-photon emission computed tomography (SPECT) staging using NeuroGam® in patients with moyamoya disease

Cerebral angiography (CA) is the gold standard for moyamoya disease (MMD) staging and diagnosis, but CA findings are not well correlated with clinical symptoms. The purpose of this study was to establish novel cerebral-perfusion-based staging for MMD that is well correlated with clinical symptoms. From 2010 to 2015, regional cerebrovascular reserve (rCVR) was examined by single-photon emission computed tomography (SPECT) using NeuroGam® (Segamicorp, Houston, TX, USA) in 30 patients (17 women, 13 men; 60 hemispheres; mean 42.0years old [range 5-60years old]) with MMD, which was diagnosed by CA and magnetic resonance angiography (MRA). Brain CT or brain magnetic resonance imaging (MRI) was used to evaluate neurological conditions such as transient ischemic attack (TIA), cerebral hemorrhage, and cerebral infarction. A novel staging system for MMD was developed by combining findings from CA, MRI, and SPECT with NeuroGam®. Our novel staging system was strongly associated with clinical symptoms. Twenty-two hemispheres out of 60 were categorized as stage I, 24 hemispheres were categorized as stage II, and 14 hemispheres were categorized as stage III. Hemispheres with higher scores exhibited a higher incidence of clinical symptoms. These findings indicate that cerebral-perfusion-based staging is predictive of MMD clinical symptoms. Perfusion-based SPECT staging correlates well with clinical symptoms and may be a reliable alternative to the Suzuki staging by CA.

Unusual Cardiomyopathies: Some May Be More Usual Than Previously Thought and Simply Underdiagnosed

Heart failure is the most common cause of hospitalization in the United States. Just as the prevalence of heart failure has increased, the number of diseases identified that result in the heart failure syndrome has escalated. Certain cardiomyopathies that have previously been regarded as very rare are being recognized with increasing frequency, because of improved imaging techniques and an increased understanding of the pathophysiologic mechanisms that result in these diseases. Improved echocardiographic techniques and methods such as spectral Doppler and 3D image rendering, along with the use of advanced diagnostic tools such as cardiac CT angiography and cardiac magnetic resonance imaging are now common. These advanced imaging methods have led to an increased appreciation of the frequency of diseases such as isolated left ventricular noncompaction and cardiac amyloidosis. Left ventricular noncompaction, once thought to occur in roughly one in one million patients, may actually be seen in fewer than one in 1000 patients. Cardiac amyloidosis, in the senile form, may exist in 80% of 80-year-old patients, although the incidence of clinical symptoms is less. As the genetic alterations that contribute to these diseases are further elucidated, improved diagnosis and a better understanding of the prognosis of these uncommon cardiomyopathies will follow.

Pulmonary function abnormalities in childhood cancer survivors treated with bleomycin.

Bleomycin is associated with pulmonary toxic side effects including pneumonitis and pulmonary fibrosis. We evaluated the prevalence of long-term pulmonary function abnormalities in children receiving bleomycin therapy in the context of current chemotherapeutic regimens. A retrospective review of patients who received bleomycin between January 1999 and December 2011 was conducted. Abnormalities in the most recent pulmonary function test (PFT) at least 1 year after diagnosis were analyzed. Two-hundred and seven patients had received bleomycin. The results of PFT performed at least 1 year from diagnosis were available for 80 patients. Median time of follow up was 3.9 years (range 1.1-11.76 years). Median cumulative dose of bleomycin was 65 IU/m(2) (range 10-120). The most common diagnoses were Hodgkin lymphoma and germ cell tumor. At least one pulmonary function abnormality was present in 42 (52.5%) patients. When classified in groups, 22.5% patients had obstructive lung disease, 7.5% had restrictive lung disease, 28.8% had hyperinflation and 14% of patients had non-uniform distribution of ventilation. Non-Hispanic patients (OR 2.81) and children younger than 8 years (OR 4.14) had higher odds of having an abnormal PFT parameter. Very few patients had pulmonary symptoms. More than half the patients who received bleomycin had subclinical pulmonary dysfunction as evidenced by abnormalities in pulmonary function tests, although the incidence of clinical symptoms was low.

Role of P2X Purinoceptor 7 in Neurogenic Pulmonary Edema after Subarachnoid Hemorrhage in Rats

IntroductionNeurogenic pulmonary edema (NPE) is an acute and serious complication after subarachnoid hemorrhage (SAH) with high mortality. The present study aimed to test the therapeutic potential of brilliant blue G (BBG), a selective P2X purinoceptor 7 (P2X7R) antagonist, on NPE in a rat SAH model.MethodsSAH was induced by endovascular perforation. 86 Sprague-Dawley rats were randomly divided into sham, vehicle-, or BBG-treatment groups. Mortality, body weight, SAH grading, neurological deficits, NPE clinical symptoms, and pulmonary index were measured at 24 hours following SAH. Western blot, gelatin zymography, lung histopathology, and immunofluorescence staining were performed in the left lung lobe to explore the underlying mechanisms at 24 hours post-surgery.ResultsThe incidence of clinical symptoms was correlated with pulmonary index. P2X7R and the marker of alveolar type I epithelial cells (the mucin-type glycoprotein T1-α) immunoreactivities were generally co-localized. BBG administration decreased mature interleukin-1β, myeloperoxidase, and matrix metallopeptidase-9 activation, but increased tight junction proteins, such as ZO-1 and occludin, which ameliorated pulmonary edema via anti-inflammation and improved neurological deficits.ConclusionP2X7R inhibition prevented NPE after SAH by attenuating inflammation. Thus, BBG is a potential therapeutic application for NPE after SAH and warrants further research.

Detection of α-Synuclein Aggregates by Fluorescence Microscopy

Parkinson disease (PD) is one of the most common age-related neurodegenerative diseases associated with motor deficiencies in humans. The symptoms are caused by the death of dopaminergic neurons in the brain, which is accompanied by the misfolding and aggregation of the protein α-synuclein. Diagnosis is based on the incidence of clinical symptoms, although they only appear as a result of the irreversible damage of neurons during the disease. Identification of a suitable biomarker would allow preclinical diagnosis. We an approach to quantify single α-synuclein aggregates as a possible biomarker for PD.

Polymorphisms of PXK are associated with autoantibody production, but not disease risk, of systemic lupus erythematosus in Chinese mainland population

Systemic lupus erythematosus (SLE) is a complex immune disease. The genetic variation in the PXK gene was found to associate with SLE in Caucasian populations. However, the association of rs6445975 with SLE has not been extensively studied in a Chinese mainland population. A total of 288 SLE patients and 357 controls were recruited. Unlabeled probe-based high-resolution melting analysis (HRMA) was used in genotyping. HRMA with unlabeled probe successfully distinguished all genotypes. Neither genotype nor allele frequencies of SNP rs6445975 showed statistically significant differences between SLE patients and controls. The association of SNP rs6445975 with the diagnostic criteria of SLE was also examined. No obvious association was observed between rs6445975 and the incidence of clinical symptoms. However, the minor allele (G) of rs6445975 was found to significantly associate with increased abnormalities of anti-Smith (p = 0.004, odds ratio (OR) = 1.95, 95% confidence interval (CI) = 1.22-3.09), anti-Ro (p = 0.015, OR = 1.69, 95% CI = 1.10-2.58), anti-La (p = 0.008, OR = 1.86, 95% CI = 1.17-2.93) and C3C4 (p = 0.007, OR = 1.79, 95% CI = 1.17-2.74). Polymorphisms of rs6445975 in the PXK gene were associated with autoantibody production, but not disease risk, of systemic lupus erythematosus in a Chinese population.

Insights from Mouse Models to Understand Neurodegeneration in Down Syndrome

Individuals with trisomy 21, also known as Down syndrome (DS), develop a clinical syndrome including almost identical neuropathological characteristics of Alzheimer's disease (AD) observed in non-DS individuals. The main difference is the early age of onset of AD pathology in individuals with DS, with hish incidence of clinical symptoms in the late 40- early 50 years of age. The neuropathology of AD in persons with DS is superimposed with the developmental abnormalities causing alterations of neuronal morphology and function. Despite the ubiquitous occurrence of AD neuropathology, clinical signs of dementia do not occur in all adults with DS even at older ages. Phenotype analysis of DS mouse models has revealed a differential age-related neurodegenerative pattern that correlates with specific biochemical and molecular alterations at the cellular level. In fact, several individual genes found in trisomy in DS have been functionally related to neuronal degeneration. Thus, mouse models overexpressing HSA21 gene(s) are fundamental to understand the neurodegenerative process in DS, as described in the present review. In addition, these models might allow to define and evaluate potential drug targets and to develop therapeutic strategies that may interfere or delay the onset of AD.

Clinical experience with symptomatic superior canal dehiscence in a single neurotologic practice

To discuss the range of signs and symptoms of patients with superior canal dehiscence syndrome identified in a single neurotologic practice. Retrospective chart review of 35 patients diagnosed with superior canal dehiscence from April 2000 to June 2007. All patients had evidence of superior canal dehiscence on computed tomography. These 35 patients represented 0.56% of new patients seen over a five-year period. The incidence of clinical symptoms and signs is compared to other published series. The mean vestibular evoked myogenic potential thresholds of affected ears are significantly lower than the mean vestibular evoked myogenic potential thresholds of unaffected ears. To date, 5 of 35 patients have undergone transmastoid occlusion of the superior semicircular canal with significant improvement in clinical symptoms in 4 of 5 cases. Not all patients with a diagnosis of superior canal dehiscence syndrome will have classic symptoms and signs. A high index of suspicion with careful clinical examination and properly performed ancillary testing is required to confirm this diagnosis.

Total splenic vein thrombosis after laparoscopic splenectomy: a possible candidate for treatment

Background Portal or splenic vein thrombosis (PSVT) is a common disorder after laparoscopic splenectomy (LS). Splenomegaly is a well-known risk factor for PSVT. However, no treatment strategy for PSVT has been established. Methods Thirty-three consecutive patients who had undergone LS and postoperative imaging surveillance were examined. PSVT was classified according to the site of thrombosis. We evaluated patient background, operative factors, and clinical symptoms. Results Spleen weight of patients with PSVT (n = 17, median 218 g) was greater than that of patients without PSVT (n = 16, median 101 g). Seven patients developed thrombosis involving the entire splenic vein (total splenic vein thrombosis), and 4 of them had clinical symptoms (fever >38°C and/or abdominal pain). The incidence of clinical symptoms was significantly more frequent in patients with than without total SVT. Operation time, blood loss, and spleen weight were also significantly greater in patients with total SVT. Multiple logistic regression analysis demonstrated spleen weight was the strongest predictor of PSVT and total SVT. Conclusion Patients with total SVT have greater risk factors for PSVT and frequently have clinical symptoms. They are candidates for anticoagulation therapy.

Total salivary IgA, serum C3c and IgA in obese school children

Studies of the immunologic function in adult obese humans and experimental models indicate that excess adiposity is associated with impairments in host defense mechanisms. The aim of this work was to analyze the secretory and humoral immune system in obese children (n = 105, 55 boys, 50 girls ), between 6 and 13 years of age. Samples of non-stimulated saliva and whole blood were collected from fasting patients. Total salivary IgA (IgAsal), serum C3 complement (C3c) and Immunoglobulin A (IgA) were determined by quantitative radial immunodifussion on agar gel layers ( Diffu-plate, Biocientı́fica SA ). Results, expressed as mg/dl, were compared to laboratory reference values from healthy children of either sex in the same range of age that belong to the same socioeconomic class (n = 60). Data (Mean ± 1 SD) of the whole population were: IgAsal: 11.4 ± 4.8 vs 14.8 ± 6.9; C3c: 190.7 ± 53.1 vs 126.3 ± 45.5; IgA: 194.5 ± 101.5 vs 157.2 ± 19.9. Data distribution showed higher frecuencies near the zone of the highest reference values for serum C3c; when results of IgA and IgAsal were expressed as percentage of the mean reference value, 51% and 48.6% of the whole studied population presented data lower than 100% and 75% respectively. These results show a compromised secretory immune system without incidence of clinical symptoms and infections, whereas humoral immunity might not be profoundly affected.

Characteristics of Epstein-Barr virus primary infection in pediatric liver transplant recipients

Background/Aim: Pediatric liver transplant recipients are at high risk of Epstein-Barr virus infection. However the incidence of clinical symptoms and the graft function at the time of acute infection remains poorly documented. The aim of this study was to monitor the clinical and biochemical events associated with primary Epstein-Barr virus infection. Methods: Clinical and biological patterns associated with Epstein-Barr virus infection were prospectively searched in 38 liver transplanted children. Polymerase chain reaction and anti-Epstein-Barr virus IgM antibodies were used at regular intervals to detect the timing of primary infection. Results: Five children (13%) had pretransplant immunity, 26 (68.5%) developed primary Epstein-Barr virus infection 15 to 90 days after transplantation and seven (18.5%) remained Epstein-Barr virus negative. The four patients with clinical symptoms at the time of infection subsequently developed post-transplant lymphoproliferative disease. A single post-transplant lymphoproliferative disease occurred in non-symptomatic patients (overall incidence 13%). No mortality was associated with post-transplant lymphoproliferative disease. Two asymptomatic patients had abnormal liver function tests possibly related to primary Epstein-Barr virus infection. Conclusion: Epstein-Barr virus primary infection occurs in 80% of seronegative patients within 3 months after OLT. Clinical symptoms are rare and closely associated with post-transplant lymphoproliferative disease. Outside post-transplant lymphoproliferative disease, the consequences of infection are marginal.

CHARACTERISTICS OF EPSTEIN-BARR VIRUS PRIMARY INFECTION IN PEDIATRIC LIVER TRANSPLANT RECIPIENTS

41 Background: Pediatric liver transplant recipients are at high risk of Epstein-Barr virus (EBV) infection following surgery. However the incidence of clinical symptoms and the graft function at the time of acute infection remains poorly documented. We report here the characteristics of primary EBV infection when occurring in pediatric liver transplant recipients. Patients and methods: Clinical and biological patterns associated with EBV infection were systematically searched in a cohort of 38 liver transplanted children (median age at OLT 20 months, range 5-158) between 1996 and 1998. Diagnosis of EBV infection was made by detection of EBV genome in peripheral blood lymphocytes using polymerase chain reaction (PCR) and/or by detection of anti-VCA IgM antibodies. Echography was used to detect abdominal lymphoid tissue. Results: Only 5 children (13%) had pretransplant immunity for EBV. Twenty-six (68.5%) developed primary EBV infection within a median of 30 days (range 15-90) following OLT. Ten had positive PCR with negative IgM. Sixteen patients had positive IgM among which PCR was positive whenever tested (n=5). Seven (18.5%) remained EBV negative on follow-up. Four (15%) had clinical symptoms at the time of infection, including necrotic tonsilitis (n=3) and impaired general condition (n=2). Two of them had concomitant PTLD liver nodules (n=2). A third PTLD occurred in one additional patient (gastric involvement) 300 days after primary asymptomatic infection. Overall incidence of PTLD was 10.5%. All three over-PTLD had full recovery following arrest of immunosuppression, one of them treated with anti-CD 20 antibodies (Mabthera®, Roche, Switzerland). No single patient had abnormal liver function tests (AST, ALT, GammaGT) related to EBV infection. Three of four PTLD had hypergammaglobulinemia, but only one of 34 non PTLD patient (cystic fibrosis). Conclusion: EBV primary infection occurs in 80% of seronegative patients within 3 months after OLT. PCR is more reliable than IgM for early diagnosis. Infection is not associated to changes of LFT's. A minority (15%) have clinical symptoms, being at high risk of full PTLD. Hypergammaglobulinemia is closely associated with PTLD.