Colonic malakoplakia in a liver transplant recipient

Area of Science:

• Gastroenterology
• Transplant Medicine
• Pathology

Background:

• Malakoplakia is a rare inflammatory disorder.
• Gastrointestinal malakoplakia is exceptionally rare in liver transplant recipients.
• Immunosuppressive therapy in transplant patients can predispose to unusual conditions.

Observation:

• A 58-year-old female liver transplant recipient on immunosuppressants presented with chronic diarrhea.
• Colonoscopy revealed patchy mucosal edema but no characteristic malakoplakia plaques.
• Diagnosis was confirmed via colon biopsies showing histiocytes with Michaelis-Gutmann bodies.

Findings:

• The case demonstrates colonic malakoplakia in a liver transplant patient.
• Malakoplakia was associated with chronic diarrhea despite absent macroscopic lesions.
• Histopathological examination confirmed the presence of Michaelis-Gutmann bodies.

Implications:

• Malakoplakia should be considered in the differential diagnosis of chronic diarrhea in transplant patients.
• The absence of visible lesions on colonoscopy does not rule out malakoplakia.
• Early diagnosis and management are crucial for improving outcomes in transplant recipients with malakoplakia.