Treatment with immunosuppressants such as corticosteroids, hydroxychloroquine, and azathioprine resulted in symptomatic improvement. However, the disease course was complicated by constrictive pericarditis requiring pericardiectomy and later inflammatory arthritis requiring escalation of immunosuppression. This case highlights the importance of considering autoimmune etiologies in patients with unexplained multisystem effusions and elevated tumor markers, thereby avoiding misdiagnosis and unnecessary oncological interventions.
Mycophenolate mofetil was discontinued, and tacrolimus levels were maintained at 6-8 ng/mL...EBV-negative PTLD is rare and often fatal. Ascitic fluid cytology can facilitate early, minimally invasive diagnosis, warranting high clinical suspicion in transplant recipients with unexplained ascites.