健康科学ジャーナル

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Posttransplant lymphoproliferative disorder presenting as a small bowel obstruction in two patients with kidney transplantation

Rahimzadeh N and Jabbari M

Solid organ transplant recipients are at an increased risk for developing malignant neoplasms. Post transplantation lymphoproliferative disorder (PTLD) is a polyclonal or monoclonal lymphoid proliferation occurs in the severe immunosuppression after solid organ transplantation. Epstein-Barr virus infection is one of the most important risk factors for PTLD, even though 40% of PTLD cases in concurrent series are not Epstein-Barr virus-associated. The overall level of immunosuppression seems to be the most important stimulant of the increased occurrence of PTLD in solid organ transplant recipients. Herein, we report two cases of polymorphic PTLD presenting with isolated gastrointestinal involvement in an Epstein-Barr virus negative in one patient with decead-donor kidney transplantation, 6 months after receiving the transplant, and the others Epstein-Barr, CMV virus and covid 19 positive with decead-donor kidney transplantation, 1 year after transplantation. Although rare, gastrointestinal PTLD can lead to small bowel obstruction or perforation in patients with a history of solid-organ transplantation. However typical symptoms may be indefinable in the immunocompromised setting, clinicians should be careful for underlying PTLD with isolated gastrointestinal involvement.

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