Disclosures: Tiffany N. Su, MD: Nothing to disclose

Case Description: Post transplant lymphoproliferative disorder (PTLD) is a rare disorder associated with solid organ transplantation or allogeneic hematopoietic cell transplantation. Its incidence has been estimated at 1-2.3% of renal transplants, usually within the first year of transplantation. Of all PTLD cases, up to 30% involve the CNS and in many cases may present as isolated CNS lesions. In the literature, cases of PTLD have discussed the etiology and medical interventions for the disease. However, no reports have been published regarding the acute rehabilitation of patients with PTLD.

Setting: Acute Inpatient Rehabilitation Hospital

Patient: A 74-year-old man with history of diabetes mellitus, hypertension, and end-stage renal disease who underwent a renal transplant in 2009, presented with gait instability for 3 months and tinnitus for 1 month. Brain magnetic resonance imaging demonstrated a mass in the right parietal lobe periventricular deep white matter. The patient underwent left frontoparietal craniotomy for biopsy of his right parietal tumor on 06/12/2018, with results showing Epstein-Barr Virus Positive PTLD. He was transferred to acute rehabilitation on post-op day 3. During his inpatient rehabilitation course, the patient participated in occupational, physical, and cognitive therapies focused on neuromuscular rehabilitation, balance training, fine motor skills, and cognitive rehabilitation.

Assessment/Results: During the patient’s acute rehabilitation, he progressed from his initial evaluation with Functional Independence Measure (FIM) scores of maximum assistance for tasks such as bed mobility, transfers, ambulation, toileting, and dressing to supervision to independent for activities of daily living (ADLs).

Discussion: This case demonstrated that a patient with functional impairments secondary to PTLD was able to make significant functional gains. The intensive comprehensive rehabilitation improved his level of independence and improved his transition home while reducing caregiver burden.

Conclusion: This case demonstrated that a patient with functional impairments secondary to PTLD was able to make significant functional gains with multidisciplinary rehabilitation.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/post-transplant-lymphoproliferative-disorder-a-rare-presentation-in-the-brain/