Development of ulcerative colitis after heart transplantation during immunosuppressive therapy

• Published in: Zeitschrift für Gastroenterologie Vol. 43; no. 2; p. 195
• Main Authors: Jüngling, B, Kindermann, I, Moser, C, Püschel, W, Ecker, K W, Schäfers, H J, Böhm, M, Zeuzem, S, Giese, T, Stallmach, A
• Format: Journal Article
• Language: English
• Published: Germany 01.02.2005
• Subjects: Biopsy; Colectomy; Colitis, Ulcerative - diagnosis; Colitis, Ulcerative - pathology; Colitis, Ulcerative - surgery; Colonoscopy; Cyclosporine - adverse effects; Cyclosporine - therapeutic use; Disease Progression; Heart Failure - surgery; Heart Transplantation; Humans; Ileostomy; Immunosuppressive Agents - adverse effects; Immunosuppressive Agents - therapeutic use; Intestinal Mucosa - pathology; Long-Term Care; Male; Middle Aged; Polymerase Chain Reaction; Postoperative Complications - diagnosis; Postoperative Complications - pathology; Postoperative Complications - surgery; Predictive Value of Tests; Prednisolone - adverse effects; Prednisolone - therapeutic use; Recurrence; Reoperation
• ISSN: 0044-2771
• DOI: 10.1055/s-2004-813743

Cardiac transplantation has become an accepted treatment modality for end-stage heart failure. Immunosuppressive agents, which are used after transplantation, are considered as therapeutic options for inflammatory bowel disease. We report on a 53-year-old patient who was treated for 2 years with cyclosporine A, azathioprine and prednisolone after heart transplantation. He developed a distal colitis with all features of ulcerative colitis. An infectious or ischemic etiology was carefully excluded. In spite of high-dose treatment with prednisolone the patient's abdominal symptoms worsened and he developed a progression of the inflammation in the entire colon and a colectomy with ileostomy was necessary. The histology was consistent with ulcerative colitis. After colectomy he recovered and remained in a good state of health. This report supports the concept that new onset inflammatory bowel disease can develop in a heart transplantation recipient in spite of immunosuppression.