Sclerosing cholangitis associated to cryptosporidiosis in liver-transplanted children

Campos, Maria Isabela Guimarães; Jouzdani, E; Sempoux, Christine; Buts, Jean-Paul; Reding, Raymond; Otte, Jean-Bernard; Sokal, Étienne

doi:10.1007/s004310050023

Cited by 48 publications

(32 citation statements)

References 9 publications

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“…Interestingly, bone marrow transplantation does not seem to confer any additional risk over that of the underlying disease (47). Although there have been a number of papers investigating the impact of cryptosporidiosis following solidorgan transplantation, their conclusions have been somewhat contradictory (18,28,48,103,125). Whether this is due to differing degrees of immune-suppression is unclear.…”

Section: Discussionmentioning

confidence: 99%

“…Cryptosporidiosis has been found in children after liver transplantation (18,48,125). In a study from Belgium of 461 children following liver transplantation, 3 developed diffuse cholangitis associated with intestinal Cryptosporidium carriage (18).…”

Section: Cryptosporidiosis In Patients Following Solid-organ Transplamentioning

confidence: 99%

“…In a study from Belgium of 461 children following liver transplantation, 3 developed diffuse cholangitis associated with intestinal Cryptosporidium carriage (18). All three required reoperation on the bile duct anastomosis, but biliary cirrhosis developed in one patient, requiring retransplantation.…”

Section: Cryptosporidiosis In Patients Following Solid-organ Transplamentioning

confidence: 99%

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Epidemiology and Clinical Features ofCryptosporidiumInfection in Immunocompromised Patients

Hunter

Nichols²

2002

Clin Microbiol Rev

490

363

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SUMMARY Cryptosporidium spp. are a major cause of diarrheal disease in both immunocompetent and immunodeficient individuals. They also cause waterborne disease in both the United States and United Kingdom. Studies on the mechanisms of immunity to cryptosporidiosis indicate the importance of the T-cell response. The spectrum and severity of disease in immunocompromised individuals with cryptosporidiosis reflect this importance since the most severe disease is seen in individuals with defects in the T-cell response. The most commonly studied group is that of patients with AIDS. These patients suffer from more severe and prolonged gastrointestinal disease that can be fatal; in addition, body systems other than the gastrointestinal tract may be affected. The widespread use of antiretroviral therapy does appear to be having a beneficial effect on recovery from cryptosporidiosis and on the frequency of infection in human immunodeficiency virus-positive patients. Other diseases that are associated with increased risk of severe cryptosporidiosis, such as primary immunodeficiencies, most notably severe combined immunodeficiency syndrome, are also predominantly associated with T-cell defects. Of the remaining groups, children with acute leukemia seem to be most at risk from cryptosporidiosis. There is less evidence of severe complications in patients with other malignant diseases or in those receiving immunosuppressive chemotherapy.

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Section: Discussionmentioning

confidence: 99%

Section: Cryptosporidiosis In Patients Following Solid-organ Transplamentioning

confidence: 99%

Section: Cryptosporidiosis In Patients Following Solid-organ Transplamentioning

confidence: 99%

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Epidemiology and Clinical Features ofCryptosporidiumInfection in Immunocompromised Patients

Hunter

Nichols²

2002

Clin Microbiol Rev

490

363

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“…It is a notorious infection in intestinal transplants (Moshfeghi et al, 2004) but has also been reported as a recrudescence disease in recipients of liver (Campos et al, 2000), kidney (Minz et al, 2004), and bone marrow (Muller et al, 2004) transplants. It may cause a diarrheal illness that can lead to significant fluid and electrolyte depletion and may be fatal.…”

Section: Cryptosporidiosismentioning

confidence: 99%

Infectious Complications in Kidney Transplantation

El‐Husseini¹,

Hassan²

2011

After the Kidney Transplant - The Patients and Their Allograft

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“…Patients with secondary immunodeficiencies, i.e. those undergoing immunosuppressive treatment before or after transplantation or undergoing chemotherapy during cancer treatment, constitute another group at high risk of acute cryptosporidiosis (Campos et al 2000;Abdo et al 2003;Hong et al 2007). Among different PID, patients with CD40 ligand deficiency (CD40L) and patients with combined immunodeficiency syndromes or interferon gamma deficiency are particularly prone to Cryptosporidium infection (Kocoshis et al 1984;Levy et al 1997;Wolska-Kuśnierz et al 2007).…”

Section: Introductionmentioning

confidence: 99%

Genotyping of Cryptosporidium isolates from human clinical cases in Poland

et al. 2008

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Cryptosporidium spp. infection is usually self-limited in immunocompetent hosts but can be severe and life threatening in children and in immunocompromised individuals including those with primary or acquired immunodeficiencies. One hundred and three faecal samples were collected from 35 hospitalised patients with different symptoms and tested for the presence of the parasite. Cryptosporidium oocysts were found in four of 35 patients (11.4%) using Ziehl-Neelsen staining of faecal smears and immunofluorescence assay, whereas 12 (34.3%) samples tested positive by nested polymerase chain reaction assay. Cryptosporidium DNA was detected in one bile sample but not in a liver tissue biopsy sample collected from a patient who suffered from sclerosing cholangitis. Sequence analysis of oocyst wall protein and beta-tubulin gene fragments revealed three different parasite species (Cryptosporidium hominis, Cryptosporidium meleagridis and Cryptosporidium parvum) in children with primary immunodeficiencies, whereas only C. parvum was found in immunocompetent individuals and in those with secondary immunodeficiencies. This study has revealed a high prevalence of Cryptosporidium infection in hospitalised patients in Poland and confirmed that molecular techniques enable a more sensitive detection of the parasite.

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Sclerosing cholangitis associated to cryptosporidiosis in liver-transplanted children

Abstract: Cryptosporidium intestinal infection may play a role in some cases of otherwise unexplained cholangiopathies in pediatric liver transplant recipients. This may lead to significant morbidity, including need for retransplantation.

Cited by 48 publications

References 9 publications

Epidemiology and Clinical Features ofCryptosporidiumInfection in Immunocompromised Patients

Epidemiology and Clinical Features ofCryptosporidiumInfection in Immunocompromised Patients

Infectious Complications in Kidney Transplantation

Genotyping of Cryptosporidium isolates from human clinical cases in Poland

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