Colonic Crohn Disease After Cardiac Transplantation

Abstract

Inflammatory bowel disease (IBD) after solid organ transplantation is rare. We report new-onset Crohn’s disease successfully treated with anti-tnfα therapy in a cardiac transplantation recipient. Our case highlights the importance of including IBD in the differential of chronic diarrhea despite significant immunosuppression and suggests that anti-tnf alpha therapy is effective in post-transplant IBD.

Gastrointestinal symptoms and endoscopy findings after pediatric solid organ transplantation: A case series

“…In one pediatric study, 4% of the patients were diagnosed with de novo IBD following kidney and liver transplantation, the prevalence being higher than among children without transplantation 23 . Other reports following de novo IBD after pediatric SOT have been mainly case reports 25,26 . After kidney transplantation, only three pediatric cases have been reported before our patient 23,27 .…”

“…23 Other reports following de novo IBD after pediatric SOT have been mainly case reports. 25,26 After kidney transplantation, only three pediatric cases have been reported before our patient. 23,27 Our patient had concomitant CMV infection, which is known to be able to trigger IBD.…”

Rapid resolution of colitis related to immunosuppressive medication after infliximab administration

“…The similarity in histology provided rationale for why immunomodulator treatment with a TNF‐alpha inhibitor such as infliximab could be effective in controlling disease in patients with mycophenolate or tacrolimus‐induced ulcers not responsive to alteration in immune suppressive regimen. Additionally, there have been patients diagnosed with IBD after solid organ transplant despite their requisite immunosuppression 13 who have been treated successfully with infliximab 14,15 . Wahbeh et al posit that mycophenolate therapy may mask the classic histologic features of IBD while not fully suppressing disease.…”

Ulcerative Colitis Following Orthotopic Cardiac Transplantation

“…It is also noted a dramatic response to treatment with anti TNF-alpha agent, infliximab, which could be promising data though some further studies are needed to confirm the efficacy and safety of infliximab in this group of patients as they pose a more complex course of disease and pathogenesis and require a multidisciplinary approach. 4 , 8 There are also some studies, suggesting prophylactic colectomy as prevention for colorectal cancers (CRC) in selected patients with IBD/PSC who developed their disease after solid organ transplantation and pose a higher risk of CRC development. 4 The case we presented along with some other cases that we reviewed, all yield a new aspect to how a disease with an immune system background can be developed during immunosuppressive therapy.…”