title: The development of eosinophilic colitis after liver transplantation in children.
abstract: Tacrolimus-based immunosuppression in pediatric liver transplant recipients is known to be associated with EGID. Our goal was to determine the incidence, risk factors, and characteristics of EGID in our pediatric liver transplantation program. This study was a retrospective analysis of 38 pediatric liver transplant recipients. Rectal mucosal biopsy was performed to evaluate for gastrointestinal PTLD and eosinophilic colitis. There were 14 patients (37%) who were diagnosed with eosinophilic colitis. The mean age at transplantation was 10.8 +/- 1.8 months. Those with eosinophilic colitis had a higher incidence of peripheral eosinophilia (p = 0.003) during the first two months following transplantation and had a higher EBV infection rate. Symptoms, such as diarrhea, hematochezia, and abdominal pain, became apparent after an average of three months; diagnoses were made at 6.9 +/- 2.0 months after transplantation. There were eight patients (57%) with elevated food-specific IgE levels. With food restriction treatment, the symptoms of patients improved. EGID should be considered when clinical symptoms are present, because symptoms of this disorder are similar to those of gastrointestinal PTLD. It should also be considered when peripheral eosinophila is detected or when EBV seroconversion develops during the first two months following transplantation.
authors.affiliation: Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-Dong Gangnam-Gu, Seoul 135-710, South Korea.
authors.forename: Jee Hyun
authors.initials: JH
authors.lastname: Lee
authors.forename: Hwa Young
authors.initials: HY
authors.lastname: Park
authors.forename: Yon Ho
authors.initials: YH
authors.lastname: Choe
authors.forename: Suk-Koo
authors.initials: SK
authors.lastname: Lee
authors.forename: Sang Il
authors.initials: SI
authors.lastname: Lee
mesh_terms: D001706:Biopsy; D003092:Colitis / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D004802:Eosinophilia / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D007413:Intestinal Mucosa / Q000473:pathology; D007723:Korea / Q000453:epidemiology; D016031:Liver Transplantation; D008297:Male; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors