Posttransplant Lymphoproliferative Disorder of the Small Bowel as an Unexpected Cause of Iron Deficiency Anemia Decades after Heart Transplantation

Siegel, Amanda B.; Boike, Justin R.; Trivedi, Itishree; Yadlapati, Rena

doi:10.14309/crj.2017.86

Cited by 7 publications

(6 citation statements)

References 11 publications

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“…Below normal current hemoglobin levels were also associated with an increased risk of PTLD, and this was confirmed by the literature [27][28][29]. This has been reported in relation to bone marrow infiltration and immune hemolytic anemia [27] and after gastrointestinal blood loss due to PTLD in the bowels [28].…”

Section: Discussionsupporting

confidence: 75%

Development and Validation of a Risk Score for Post-Transplant Lymphoproliferative Disorders among Solid Organ Transplant Recipients

Santos

Wareham

Mocroft

et al. 2022

Cancers

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Post-transplant lymphoproliferative disease (PTLD) is a well-recognized complication after transplant. This study aimed to develop and validate a risk score to predict PTLD among solid organ transplant (SOT) recipients. Poisson regression identified predictors of PTLD with the best fitting model selected for the risk score. The derivation cohort consisted of 2546 SOT recipients transpanted at Rigshospitalet, Copenhagen between 2004 and 2019; 57 developed PTLD. Predictors of PTLD were high-risk pre-transplant Epstein–Barr Virus (EBV), IgG donor/recipient serostatus, and current positive plasma EBV DNA, abnormal hemoglobin and C-reactive protein levels. Individuals in the high-risk group had almost 7 times higher incidence of PTLD (incidence rate ratio (IRR) 6.75; 95% CI: 4.00–11.41) compared to the low-risk group. In the validation cohort of 1611 SOT recipients from the University Hospital of Zürich, 24 developed PTLD. A similar 7 times higher risk of PTLD was observed in the high-risk group compared to the low-risk group (IRR 7.17, 95% CI: 3.05–16.82). The discriminatory ability was also similar in derivation (Harrell’s C-statistic of 0.82 95% CI (0.76–0.88) and validation (0.82, 95% CI:0.72–0.92) cohorts. The risk score had a good discriminatory ability in both cohorts and helped to identify patients with higher risk of developing PTLD.

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Section: Discussionsupporting

confidence: 75%

Development and Validation of a Risk Score for Post-Transplant Lymphoproliferative Disorders among Solid Organ Transplant Recipients

Santos

Wareham

Mocroft

et al. 2022

Cancers

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“…PTLD can also involve other organs such as central nervous system, bone marrow, spleen, lung, liver, and kidney [ 7 ]. PTLD involvement of small bowel in the form of GI bleed and viral infection has been reported previously [ 10 – 13 ]. However, a stricture in the small bowel from healed lymphomatous ulcer causing obstruction and needing endoscopic dilation has not been reported to our knowledge.…”

Section: Discussionmentioning

confidence: 96%

Late-Onset Posttransplant Lymphoproliferative Disorder Results in Jejunal Stricture Managed with Endoscopic Dilation

Park

Miller

Cheong

et al. 2021

Case Reports in Gastrointestinal Medicine

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Background. Late-onset posttransplant lymphoproliferative disorder (PTLD) after orthotopic heart transplantation is rare. Case Presentation. We present a rare diagnosis of small bowel stricture caused by healed lymphomatous ulcers in a patient with orthotopic heart transplantation and PTLD diagnosed 25 years after initial transplantation. We also demonstrate successful endoscopic balloon dilations that improved the patient’s obstructive symptoms. Conclusion. It is important to consider stricture from healed lymphomatous ulcers in posttransplant patients presenting with obstructive symptoms.

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“…La región distal del intestino delgado es el sitio más frecuente de afectación del tracto gastrointestinal en el SLPT, seguido por el colon proximal, el estómago, el duodeno y el esófago 28,34 . Más de la mitad de los SLPT muestran compromiso del intestino delgado, aunque es rara la afectación aislada del tracto gastrointestinal, acompañándose en general de compromiso nodal, usualmente mesentérico 35 (Fig. 4).…”

Section: Tracto Gastrointestinalunclassified

Todo sobre una entidad poco conocida: el síndrome linfoproliferativo postrasplante

Mariano¹,

Álvarez²,

Sabbione³

et al. 2023

RAR

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El síndrome linfoproliferativo postrasplante (SLPT o PTLD por sus siglas en inglés, posttransplantation lymphoproliferative disorder) consiste en un grupo heterogéneo de enfermedades linfoproliferativas que ocurren en el marco de la inmunosupresión postrasplante, que pueden abarcar desde una simple hiperplasia linfoidea hasta un linfoma maligno de alto grado, con eventual evolución fatal. Se estima su desarrollo entre el 1 y el 20% de los pacientes trasplantados. Los principales factores asociados con el desarrollo de SLPT son el grado de inmunosupresión y el virus de Epstein Barr (VEB). La mayoría suceden dentro del primer año postrasplante, pero el riesgo de desarrollarlo continúa hasta los 10 años. Su presentación es variable, puede ser asintomático o con manifestaciones inespecíficas (fiebre, linfadenopatías), lo que dificulta su diagnóstico desde el punto de vista clínico. Por este motivo, los métodos de imagen cumplen un rol fundamental en su diagnóstico, siendo la tomografía computada (TC) el más utilizado. Se deberá sospechar desde las imágenes en todo paciente trasplantado con afección nodal, principalmente en retroperitoneo y mesenterio; y/o extranodal, como el tracto gastrointestinal, órganos y el sistema nervioso central. El objetivo del presente trabajo consiste en realizar una revisión sobre el SLPT mediante las imágenes y conocer la importancia de su sospecha y diagnóstico.

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Posttransplant Lymphoproliferative Disorder of the Small Bowel as an Unexpected Cause of Iron Deficiency Anemia Decades after Heart Transplantation

Cited by 7 publications

References 11 publications

Development and Validation of a Risk Score for Post-Transplant Lymphoproliferative Disorders among Solid Organ Transplant Recipients

Development and Validation of a Risk Score for Post-Transplant Lymphoproliferative Disorders among Solid Organ Transplant Recipients

Late-Onset Posttransplant Lymphoproliferative Disorder Results in Jejunal Stricture Managed with Endoscopic Dilation

Todo sobre una entidad poco conocida: el síndrome linfoproliferativo postrasplante

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