A dance teacher with kidney–pancreas transplant and diarrhoea: what is the cause?

Burdese, Manuel; Veglio, Valerio; Consiglio, Valentina; Soragna, Giorgio; Mezza, Elisabetta; Bergamo, Daniela; Tattoli, Fabio; Rossetti, Maura; Jeantet, A; Segoloni, Giuseppe; Piccoli, Giorgina Barbara

doi:10.1093/ndt/gfh881

Cited by 14 publications

(16 citation statements)

References 8 publications

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“…In an 18-month observational study in Brazil, C. parvum infection was found in 35% of renal transplant recipients, 25% of haemodialysis patients and 17.4% of the control group patients [23]. The prevalence of Cryptosporidium infection in Europe has been estimated to be 1-2%, which is less than that reported in emerging countries [8]. Cryptosporidiosis in renal transplant recipients can be more severe and associated with possible sclerosing cholangitis [1,2,6,8,10,12,13,[22][23][24][25][26][27][28][29].…”

Section: Discussionmentioning

confidence: 98%

“…The prevalence of Cryptosporidium infection in Europe has been estimated to be 1-2%, which is less than that reported in emerging countries [8]. Cryptosporidiosis in renal transplant recipients can be more severe and associated with possible sclerosing cholangitis [1,2,6,8,10,12,13,[22][23][24][25][26][27][28][29]. In children, Cryptosporidial enteritis has been described after liver transplantation [1,10,14,20,30] and once after renal transplantation [13].…”

Section: Discussionmentioning

confidence: 99%

“…Treatment of Cryptosporidium-induced diarrhoea includes intravenous rehydration, nutritional support, different antiparasitic agents and reduction of immunosuppression [13]. It is important to reduce the immunosuppressive treatment as much as possible as the severity of the disease is associated to the degree of immunosuppression [1,2,6,8,10,12,13,[23][24][25][26][27][28][29].…”

Section: Discussionmentioning

confidence: 99%

“…In immunocompetent hosts, cryptosporidiosis is responsible for a selflimited disease lasting 10-14 days. The prevalence of Cryptosporidium infection is higher in poorly developed countries (5 to 20 %) than in Europe (1-2 %) where contamination is linked to swimming-pool water, day-care centers and the use of communal restrooms [8][9][10]. Infection with Cryptosporidium is also a frequent cause of traveller's diarrhoea [7,8].…”

Section: Introductionmentioning

confidence: 99%

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Cryptosporidiosis in paediatric renal transplantation

Bandı́n¹,

Kwon

Linas

et al. 2009

Pediatr Nephrol

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Diarrhoea in transplantation may be secondary to infectious agents and immunosuppressive drugs. The use of combined immunosuppressive drugs increases the incidence of infectious diarrhoea. We retrospectively collected all diarrhoea episodes during a 3-year period in 199 pediatric renal transplant recipients, including 47 patients receiving a kidney transplant during this period. We diagnosed 64 diarrhoea episodes (32% of the patients, 10.7% per year). Fourteen diarrhoea episodes could be attributed to the immunosuppressive treatment, and 12 remained without diagnosis. Nineteen patients (<10%) receiving mycophenolic acid (MPA) developed diarrhoea, 14 of whom had episodes attributable to the immunosuppressive treatment. Reducing the MPA dose or switching to another immunosuppressant did not induce graft rejection, if at all, for at least 6 months. Thirty-eight diarrhoea episodes were caused by infectious agents: viruses in 16 patients, bacterial agents in ten patients, Candida albicans in four cases and parasitic agents in eight cases (Giardia lambdia in one patient and Cryptosporidium in seven patients). In our cohort, Cryptosporidium was responsible for 18% of the infectious diarrhoea and 11% of all causes of diarrhoea, and it affected 3.5% of the newly transplanted patients during the 3-year study period. The clinical presentation of the disease was profuse and persistent diarrhoea with acute renal failure in all patients. We propose that oocysts be screened for in the stool during the early stages of tests for determining the origin of infectious diarrhoea. Disease treatment requires early specific treatment (nitazoxanide) for extended periods of time in conjunction with supportive rehydration.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Cryptosporidiosis in paediatric renal transplantation

Bandı́n¹,

Kwon

Linas

et al. 2009

Pediatr Nephrol

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“…[1][2][3][4][5][6][7] There are a few reports of mass infection of Cryptosporidium in Japan, but cryptosporidiosis in allo-HSCT has not been reported in Japan, based on a literature search. A few disseminated cryptosporidiosis cases have been reported in hospitalized post allo-HSCT patients during treatment of acute GVHD, similar to our patient.…”

Section: Diagnosis and Treatmentmentioning

confidence: 99%

Cryptosporidiosis in a transplant recipient with severe intractable diarrhea: Detection of Cryptosporidium oocysts by intestinal biopsies

Kagawa

Fujino

Miki

et al. 2018

Transplant Infectious Dis

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Disseminated Cryptosporidium infection results in manifestations similar to those of graft‐versus‐host disease (GVHD), which hampers the detection of Cryptosporidium infection after allogeneic hematopoietic stem cell transplantation. Surveillance of oocysts on the surface of intestinal epithelial cells is needed for early and appropriate detection of Cryptosporidium infection in transplant recipients on immunosuppressants with severe intractable diarrhea. We present the first case of Cryptosporidium meleagridis infection in Japan after allogeneic cord blood transplantation.

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