امرأة عمرها ٤٢ سنة بعد زرع رئة قبل ٤ أشهر، تأخذ تاكروليموس وموفيتيل وكورتيزون، وتقيس وظائف الرئة في البيت يومياً. تتصل بالعيادة بعدة ملاحظات. أي عرض يبلغ عنه فوراً؟

A 42-year-old woman 4 months after lung transplant takes tacrolimus, mycophenolate and prednisolone and measures her lung function at home daily. She calls the clinic with several observations. Which must be reported immediately?

1. A mild hand tremor present since starting the drugs
2. Increased appetite and slight weight gain
3. Falling home FEV1 with dyspnoea and fever
4. Extra hair growth on the face and arms

Answer: C) Falling home FEV1 with dyspnoea and fever. Falling home FEV1, dyspnoea and fever may mean rejection or infection, both needing urgent review. Tremor, hair growth and appetite changes are known drug effects.