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Case Reports
, 2018, 3264921
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Neutropenic Enterocolitis in a Pediatric Heart Transplant Recipient on Multiple Immunosuppressants

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Case Reports

Neutropenic Enterocolitis in a Pediatric Heart Transplant Recipient on Multiple Immunosuppressants

Emily E Miller et al. Case Rep Transplant.

Abstract

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.

Figures

Figure 1
Figure 1
Abdominal X-ray (KUB) showing pneumatosis intestinalis, as evidenced by linear lucencies in the cecum (white arrows) and diffusely edematous bowel (black arrows).

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Cited by 1 PubMed Central articles

  • Neutropenic Enterocolitis: A Clinico-Pathological Review
    R Xia et al. World J Gastrointest Pathophysiol 10 (3), 36-41. PMID 31692935.
    Neutropenic enterocolitis (NE) is a predominantly cecum-based disease with high mortality seen in patients post chemotherapy. The pathogenesis of NE is poorly understood …

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