title: Clinical, endoscopic, and histologic features of eosinophilic inflammation of the gastrointestinal tract in pediatric liver transplant patients.
abstract: Immunosuppression during the post-transplantation period has led to dramatic outcome improvements in PLTR patients. There have been reports describing the development of food allergies and an increased predilection for development of EGI in PLTR. We aimed to identify the clinical, endoscopic and histologic features of EGI in PLTR patients. In this retrospective case series we analyzed medical record of all PLTR who underwent EGD and/or colonoscopy at our institution from 2000 to 2006. From 2000 to 2006, 32 PLTR patients underwent endoscopic evaluation. Seventeen (53%) of 32 patients were diagnosed with EGI. Endoscopic abnormalities were seen in the esophagus, stomach, and small intestine in 11 (65%), 11 (65%), and four (24%) patients, respectively. Eosinophilic inflammation was seen in the esophagus, stomach, and small intestine in 13 (76%), 10 (59%), and five (29%) patients, respectively. Nine of 17 patients underwent colonoscopy and endoscopic abnormalities were seen in four (44%) patients. Five patients (56%) had eosinophilic inflammation. In conclusion, we have characterized the clinical, endoscopic, and histologic features of EGI. Histologic and endoscopic examination reveals that, when present, EGI is often found at multiple segments along the gastrointestinal tract.
authors.affiliation: Indiana University School of Medicine, James Whitcomb Riley Hospital for Children, Pediatric Gastroenterology, Hepatology and Nutrition, Indianapolis, IN, USA.
authors.forename: Kalyan Ray
authors.initials: KR
authors.lastname: Parashette
authors.forename: Meltem
authors.initials: M
authors.lastname: Zeytinoglu
authors.forename: Kevin
authors.initials: K
authors.lastname: Kernek
authors.forename: Jean P
authors.initials: JP
authors.lastname: Molleston
authors.forename: Girish
authors.initials: G
authors.lastname: Subbarao
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003113:Colonoscopy; D004804:Eosinophils / Q000378:metabolism*; D004947:Esophagus / Q000473:pathology; D005260:Female; D005512:Food Hypersensitivity / Q000209:etiology; D041981:Gastrointestinal Tract / Q000473:pathology*; D006801:Humans; D007223:Infant; D007249:Inflammation / Q000175:diagnosis / Q000209:etiology*; D007421:Intestine, Small / Q000473:pathology; D017093:Liver Failure / Q000150:complications / Q000628:therapy*; D016031:Liver Transplantation; D008297:Male; D012189:Retrospective Studies; D013270:Stomach / Q000473:pathology
keywords: endoscopy; eosinophilic colitis; eosinophilic gastrointestinal disease; food allergy; gastrointestinal eosinophilia; pediatric liver transplant; tacrolimus