Abstract：
UNASSIGNED: Gastrointestinal complications are common in kidney transplant (KT) patients and can be a consequence of the chronic use of immunosuppression. The differential diagnosis of colitis in KT patients includes intolerance to immunosuppressive agents, namely mycophenolate mofetil, de novo inflammatory bowel disease (IBD) and opportunistic infections. Epstein-Barr virus (EBV) infection may cause post-transplant colitis or trigger de novo IBD, although is seldom thought as the causative pathogen.
UNASSIGNED: To describe clinical characteristics, endoscopic and histological findings, treatment and outcome of three patients that developed EBV associated colitis following kidney transplantation.
UNASSIGNED: We retrospectively analyzed three patients with EBV associated colitis; clinical data including transplantation, gastrointestinal symptoms, endoscopy findings, and follow-up data was obtained.
UNASSIGNED: We present a case series of three patients with EBV colitis following KT, with an average age at clinical presentation of 59 years and elapsed time since the KT ranging from five to 22 years. Clinical manifestations included bloody diarrhoea, abdominal pain, weight loss and/or fever. Cytomegalovirus colitis, mycophenolate mofetil-related colitis, lymphoproliferative disease and graft versus host disease were excluded. One patient had a prior diagnosis of IBD. Two of the three patients had an unfavourable outcome with death despite reduction and/or switching of immunosuppressants, optimal medical treatment (including antiviral and intravenous immunoglobulin therapies) and salvage surgical therapy.
UNASSIGNED: A multidisciplinary approach is necessary to allow an expeditious diagnosis of a rare entity such as EBV associated colitis in KT. Long-term surveillance of these patients and the development of effective and safe therapies is essential.
UNASSIGNED: To describe clinical characteristics, endoscopic and histological findings, treatment and outcome of three patients that developed EBV associated colitis following kidney transplantation.
UNASSIGNED: We retrospectively analyzed three patients with EBV associated colitis; clinical data including transplantation, gastrointestinal symptoms, endoscopy findings, and follow-up data was obtained.
UNASSIGNED: We present a case series of three patients with EBV colitis following KT, with an average age at clinical presentation of 59 years and elapsed time since the KT ranging from five to 22 years. Clinical manifestations included bloody diarrhoea, abdominal pain, weight loss and/or fever. Cytomegalovirus colitis, mycophenolate mofetil-related colitis, lymphoproliferative disease and graft versus host disease were excluded. One patient had a prior diagnosis of IBD. Two of the three patients had an unfavourable outcome with death despite reduction and/or switching of immunosuppressants, optimal medical treatment (including antiviral and intravenous immunoglobulin therapies) and salvage surgical therapy.
UNASSIGNED: A multidisciplinary approach is necessary to allow an expeditious diagnosis of a rare entity such as EBV associated colitis in KT. Long-term surveillance of these patients and the development of effective and safe therapies is essential.
摘要：
■胃肠道并发症在肾移植（KT）患者中很常见，并且可能是长期使用免疫抑制的结果。KT患者结肠炎的鉴别诊断包括对免疫抑制剂不耐受，即霉酚酸酯，从头炎症性肠病（IBD）和机会性感染。EB病毒（EBV）感染可能导致移植后结肠炎或引发从头IBD，尽管很少被认为是致病病原体。
■为了描述临床特征，内窥镜和组织学发现，3例肾移植后发生EBV相关性结肠炎的患者的治疗和结果。
■我们回顾性分析了3例EBV相关性结肠炎患者的临床资料，包括移植、胃肠道症状,内窥镜检查结果，并获得随访数据。
■我们介绍了一系列3例KT后EBV结肠炎患者，临床表现时的平均年龄为59岁，自KT起的时间为5至22岁。临床表现包括血性腹泻，腹痛,体重减轻和/或发烧。巨细胞病毒性结肠炎，霉酚酸酯相关性结肠炎，淋巴增生性疾病和移植物抗宿主病被排除.一名患者先前诊断为IBD。尽管减少和/或转换了免疫抑制剂，但三名患者中有两名患者的死亡结果不利。最佳药物治疗（包括抗病毒和静脉注射免疫球蛋白治疗）和挽救性手术治疗。
■多学科方法对于快速诊断KT中的罕见实体如EBV相关性结肠炎是必要的。对这些患者进行长期监测以及开发有效和安全的疗法至关重要。
■为了描述临床特征，内窥镜和组织学发现，3例肾移植后发生EBV相关性结肠炎的患者的治疗和结果。
■我们回顾性分析了3例EBV相关性结肠炎患者的临床资料，包括移植、胃肠道症状,内窥镜检查结果，并获得随访数据。
■我们介绍了一系列3例KT后EBV结肠炎患者，临床表现时的平均年龄为59岁，自KT起的时间为5至22岁。临床表现包括血性腹泻，腹痛,体重减轻和/或发烧。巨细胞病毒性结肠炎，霉酚酸酯相关性结肠炎，淋巴增生性疾病和移植物抗宿主病被排除.一名患者先前诊断为IBD。尽管减少和/或转换了免疫抑制剂，但三名患者中有两名患者的死亡结果不利。最佳药物治疗（包括抗病毒和静脉注射免疫球蛋白治疗）和挽救性手术治疗。
■多学科方法对于快速诊断KT中的罕见实体如EBV相关性结肠炎是必要的。对这些患者进行长期监测以及开发有效和安全的疗法至关重要。
