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Graft-vs-Host Disease Colitis After Lung Transplant
Kavin Kanthasamy1, Mimi Tan Chang2, Manreet Kaur2
1Division of Internal Medicine, John's Hopkins Hospital, Baltimore, MD.
ACG Case Reports Journal
|April 21, 2020
Summary
Graft-vs-host disease is rare after solid organ transplants. This case highlights its occurrence post-lung transplant, successfully treated with infliximab and photophoresis.
Area of Science:
- Immunology
- Gastroenterology
- Transplantation Medicine
Background:
- Graft-vs-host disease (GvHD) is a known complication of allogeneic hematopoietic stem cell transplantation.
- GvHD following solid organ transplantation is exceptionally rare.
Observation:
- A 50-year-old male developed abdominal pain, vomiting, and diarrhea post-bilateral lung transplantation.
- Colonoscopy revealed severe active colitis with ulceration and crypt apoptosis, indicative of GvHD colitis.
- Donor lymphocyte presence in peripheral blood confirmed the GvHD diagnosis.
Findings:
- The patient's GvHD symptoms were refractory to initial corticosteroid treatment.
- Combination therapy with infliximab and extracorporeal photophoresis led to symptom resolution.
- The patient achieved sustained remission for 17 months post-treatment.
Implications:
- This case expands the understanding of GvHD occurrence in solid organ transplantation.
- It suggests infliximab and extracorporeal photophoresis as potential therapeutic options for refractory GvHD post-lung transplant.
- Highlights the importance of considering GvHD in post-transplant gastrointestinal complications.
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