Posttransplantation Lymphoproliferative Disorder after Liver Transplantation in Pediatric Patients: Report from a Single-center Over 21 Years / 대한소아소화기영양학회지
Korean Journal of Pediatric Gastroenterology and Nutrition
;
: 199-206, 2009.
Article
Dans Coréen
| WPRIM
| ID: wpr-49620
ABSTRACT
PURPOSE:
To analyze the clinical spectrum of posttransplantation lymphoproliferative disorder (PTLD) after liver transplantation in children.METHODS:
From January 1988 to June 2009, we retrospectively reviewed the medical records of 8 PTLD cases among 148 pediatric patients underwent liver transplantation. The age at transplantation, time of presentation after transplantation, clinical manifestations, histologic diagnosis, results of EBV (Epstein-Barr virus) assessments, managements and outcomes of PTLD were investigated.RESULTS:
The prevalence of PTLD in liver transplant pediatric recipients was 5.4% (8 of 148). The mean age of patients was 25.4+/-21.3 months (range 10 to 67 months). Seven of 8 patients (87.5%) underwent liver transplantation before 1 year of age. The common clinical presentations were persistent fever (8 of 8, 100%) and bloody diarrhea (6 of 8, 75%). PTLD was diagnosed with gastrointestinal endoscopic biopsies in five patients and surgical biopsies in three. Histologic findings showed early lesion in three patients, polymorphic in two, and monomorphic in three. Burkitt lymphoma and lymphoblastic lymphoma were found in two of 3 monomorphic patients. Seven of 8 patients were found with EBV-positive. Eight patients were treated with dose reduction of immunosuppressants and infusion of ganciclovir. Rituximab was added to four patients. PTLD were successfully managed in all patients except one who died of sepsis during chemotherapy.CONCLUSION:
Major risk factor of PTLD was to undergo liver transplantation before 1 year of age. Continuous monitoring for EBV viral load and gastrointestinal endoscopic biopsy may be useful to early detection of PTLD.
Texte intégral:
Disponible
Indice:
WPRIM (Pacifique occidental)
Sujet Principal:
Biopsie
/
Ganciclovir
/
Dossiers médicaux
/
Prévalence
/
Études rétrospectives
/
Facteurs de risque
/
Lymphome de Burkitt
/
Transplantation hépatique
/
Herpèsvirus humain de type 4
/
Sepsie
Type d'étude:
Etude d'étiologie
/
Étude observationnelle
/
Étude de prévalence
/
Facteurs de risque
/
Étude de dépistage
Limites du sujet:
Enfant
/
Humains
langue:
Coréen
Texte intégral:
Korean Journal of Pediatric Gastroenterology and Nutrition
Année:
2009
Type:
Article
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