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Neutropenic Enterocolitis in a Pediatric Heart Transplant Recipient on Multiple Immunosuppressants

Neutropenic enterocolitis (NE) historically primarily affects pediatric patients with leukemia who are undergoing chemotherapy or who have recently received bone marrow transplants. Although a few case reports have shown NE occurring outside of this typical population, to our knowledge, this is the...

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Autores principales: Miller, Emily E., Reardon, Leigh Christopher
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5964482/
https://www.ncbi.nlm.nih.gov/pubmed/29854547
http://dx.doi.org/10.1155/2018/3264921
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author Miller, Emily E.
Reardon, Leigh Christopher
author_facet Miller, Emily E.
Reardon, Leigh Christopher
author_sort Miller, Emily E.
collection PubMed
description Neutropenic enterocolitis (NE) historically primarily affects pediatric patients with leukemia who are undergoing chemotherapy or who have recently received bone marrow transplants. Although a few case reports have shown NE occurring outside of this typical population, to our knowledge, this is the first published case of NE occurring in the setting of pediatric heart transplant. This patient was diagnosed several months after pediatric heart transplant, with radiographs showing evidence of pneumatosis intestinalis. Although NE does not typically affect solid organ transplant patients, this patient had a variety of risk factors that may have predisposed her to development of NE such as severe neutropenia, supratherapeutic tacrolimus level, immunosuppression with cytotoxic agents, and elevated Epstein-Barr viral load. Fortunately, this patient improved with bowel rest, fluids, antibiotics, and alteration of her immunosuppressive regimen. However, NE can be fatal, and thus it is an important condition to consider, even in patients without leukemia or on chemotherapeutic regimens.
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spelling pubmed-59644822018-05-31 Neutropenic Enterocolitis in a Pediatric Heart Transplant Recipient on Multiple Immunosuppressants Miller, Emily E. Reardon, Leigh Christopher Case Rep Transplant Case Report Neutropenic enterocolitis (NE) historically primarily affects pediatric patients with leukemia who are undergoing chemotherapy or who have recently received bone marrow transplants. Although a few case reports have shown NE occurring outside of this typical population, to our knowledge, this is the first published case of NE occurring in the setting of pediatric heart transplant. This patient was diagnosed several months after pediatric heart transplant, with radiographs showing evidence of pneumatosis intestinalis. Although NE does not typically affect solid organ transplant patients, this patient had a variety of risk factors that may have predisposed her to development of NE such as severe neutropenia, supratherapeutic tacrolimus level, immunosuppression with cytotoxic agents, and elevated Epstein-Barr viral load. Fortunately, this patient improved with bowel rest, fluids, antibiotics, and alteration of her immunosuppressive regimen. However, NE can be fatal, and thus it is an important condition to consider, even in patients without leukemia or on chemotherapeutic regimens. Hindawi 2018-05-08 /pmc/articles/PMC5964482/ /pubmed/29854547 http://dx.doi.org/10.1155/2018/3264921 Text en Copyright © 2018 Emily E. Miller and Leigh Christopher Reardon. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Miller, Emily E.
Reardon, Leigh Christopher
Neutropenic Enterocolitis in a Pediatric Heart Transplant Recipient on Multiple Immunosuppressants
title Neutropenic Enterocolitis in a Pediatric Heart Transplant Recipient on Multiple Immunosuppressants
title_full Neutropenic Enterocolitis in a Pediatric Heart Transplant Recipient on Multiple Immunosuppressants
title_fullStr Neutropenic Enterocolitis in a Pediatric Heart Transplant Recipient on Multiple Immunosuppressants
title_full_unstemmed Neutropenic Enterocolitis in a Pediatric Heart Transplant Recipient on Multiple Immunosuppressants
title_short Neutropenic Enterocolitis in a Pediatric Heart Transplant Recipient on Multiple Immunosuppressants
title_sort neutropenic enterocolitis in a pediatric heart transplant recipient on multiple immunosuppressants
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5964482/
https://www.ncbi.nlm.nih.gov/pubmed/29854547
http://dx.doi.org/10.1155/2018/3264921
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