Figure 1.

Chart shows the timeline of Case 1's symptoms, clinical progress, laboratory findings and immunosuppression management. The patient was started with lopinavir/ritonavir on admission, resulting in significant drug interaction with cyclosporine, high cyclosporine levels, followed by hepatocellular transaminitis. Cyclosporine and mycophenolate sodium doses were titrated based on drug levels and clinical condition. He was de-isolated on Day 20 of illness after two negative PCR swabs (−), but in view of the rising ferritin trend, a repeat PCR swab was done on Day 23 and found to be positive (+), resulting in re-isolation. Ferritin and transaminase levels eventually improved, and he was discharged on Day 37 of illness after two negative PCR swabs. ×: cyclosporine dose withheld, ALT: alanine aminotransferase, AST: aspartate aminotransferase, C0: cyclosporine trough level, C2: cyclosporine level two hours after dose, PCR: polymerase chain reaction