pattern molecules (DAMPs) and pathogen-associated molecular pattern molecules (PAMPs) and their interaction with toll-like receptors has been described (1,2). Management of these cases is more challenging given the tendency for more severe cases, the risk of infection with the addition of more immunosuppression, and the possibility of drug-drug interactions that further complicate treatment decisions. Herein we describe 2 cases of IBD with onset of symptoms after SOT. METHODS: Clinical Case reports: Description of the cases: (Table 1 summarizes the characteristics and clinical course of the 2 cases). Case 1: A 37-year-old male underwent OLT at age of 21 for end stage liver disease secondary to autoimmune hepatitis. He presented with diarrhea 2 years after the transplantation and was diagnosed with UC based on the endoscopic and pathological evaluation and after ruling out infectious etiology. Case 2: A 45-year-old male underwent deceased donor renal transplantation in August 2010 for ESRD of unknown etiology. Three years after the transplantation, he presented with diarrhea and Crohn's disease (CD) was diagnosed based on the endoscopic findings and after ruling out any infectious etiology (Fig. 1). RESULTS: In case 1, patient developed refractory UC requiring colectomy 2 years post-transplantation. This is consistent with the reported literature as post-SOT IBD cases were noted to have an onset after the first year of transplantation and generally have more aggressive course compared to pretransplantation cases (1,4). In case 2 the onset of symptoms started few months after he was switched from tacrolimus to sirolimus. Tacrolimus is a calcineurin inhibitor used to prevent chronic rejection after SOT and previously used for induction of remission in refractory UC. Interestingly, it was also found to be one of the risk factors for the development of IBD following SOT. Donor-recipient CMV mismatch is the other statistically significant risk factor. Sirolimus on the other hand is an mTOR inhibitor that inhibits B and T cell activation by arresting cell-cycle progression. It has no known effect on IBD (2). While it might be surprising that the patient developed CD after the immunosuppressive medications switch, sirolimus is a relatively newer medication and more studies is warranted to evaluate its role in this complex immune process. CONCLUSIONS: While it continues to be increasingly reported in literature, de novo and recurrent IBD following SOT is still poorly understood and remain challenging in both diagnosis and management. P-011 YI BACKGROUND: Inflammatory bowel disease (IBD) is associated with a 2 to 3 fold increased risk of thromboembolism, including deep vein thrombosis (DVT) and pulmonary embolism (PE). Pregnancy and the post partum period have been associated with a 4 to 5 fold increased risk of thromboembolism in women of childbearing age. The purpose of this study was to determine the incidence and risk factors for the development of thromboembolism in hospitalized pregnant women with IBD. METHODS: The C...
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