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De novo inflammatory bowel disease after pediatric kidney or liver transplant
Author(s) -
Fernandes Melissa A.,
Braun Hillary J.,
Evason Kim,
Rhee Sue,
Perito Emily R.
Publication year - 2017
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.12835
Subject(s) - medicine , inflammatory bowel disease , immunosuppression , ulcerative colitis , hematochezia , gastroenterology , kidney disease , kidney , liver disease , disease , colonoscopy , colorectal cancer , cancer
A subset of children who receive a liver and/or kidney transplant develop de novo inflammatory bowel disease‐like chronic intestinal inflammation, not explained by infection or medications, following transplant. We have conducted a single‐center, retrospective case series describing the unique clinical and histologic features of this IBD ‐like chronic intestinal inflammation following solid organ transplant. At our center, nine of 327 kidney or liver recipients developed de novo IBD following transplant (six liver, two kidney, one liver‐kidney). Most children presented with prolonged hematochezia and diarrhea and were treated with aminosalicylates. At time of diagnosis, five were not currently using mycophenolate mofetil for transplant immunosuppression. Histologic and endoscopic findings at IBD diagnosis included inflammation, ulcerations, granulomas, and chronic colitis. Since diagnosis, no patients have required surgical intervention, or escalation to biologic therapy, nor developed stricturing or perianal disease. In this case series, de novo post‐transplant IBD developed in 4% of pediatric liver and/or kidney recipients; however, it often does not fit the classic patterns of Crohn's disease or ulcerative colitis.