Abstract | BACKGROUND: METHODS AND RESULTS: We describe 6 patients with severe cutaneous complications after small bowel transplantation, the work-up, final diagnosis, and evolution. Two patients died from chronic GVHD or unrecognized drug rash with eosinophilia and systemic symptoms, the others recovered completely. In 2 patients, drugs and viruses could be implicated, and in 1 patient may have hidden or triggered chronic GVHD. Viruses (human herpesvirus 6, Epstein-Barr virus, and cytomegalovirus) were suspected to trigger drug rash with eosinophilia and systemic symptoms or GVHD. The 2 cases of acute GVHD were reversed completely by increased immunosuppression and anti-interleukin-2 receptor antibody. DISCUSSION: In these severe cases, diagnosis is urgent and should include a careful evaluation of drug history, clinical presentation, biological investigations, infections, and toxic screening. A skin biopsy and chimerism study should be performed whenever possible. An early treatment is key to a positive outcome.
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Authors | Caroline Cruysmans, Marie-Gabrielle Ferneiny, Sylvie Fraitag, Pierre Frange, Christophe Chardot, Christine Bodemer, Olivier Goulet, Florence Lacaille |
Journal | Transplantation
(Transplantation)
Vol. 100
Issue 10
Pg. 2222-5
(10 2016)
ISSN: 1534-6080 [Electronic] United States |
PMID | 26950725
(Publication Type: Journal Article)
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Topics |
- Child
- Child, Preschool
- Drug Hypersensitivity Syndrome
(etiology)
- Female
- Graft vs Host Disease
(etiology)
- Humans
- Intestine, Small
(transplantation)
- Male
- Postoperative Complications
(etiology)
- Skin Diseases
(etiology)
- Virus Diseases
(etiology)
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