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Rita Carvalho, Nuno Almeida, Francisco Portela, Dário Gomes, Carlos Gregório, Hermano Gouveia, Carlos Sofia, Terminal ileitis in a renal transplanted patient: Could it be infectious ileitis, crohn's disease, or pharmacological toxicity?, Inflammatory Bowel Diseases, Volume 17, Issue 6, 1 June 2011, Pages E52–E53, https://doi.org/10.1002/ibd.21701
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To the Editor:
Diarrhea is a common problem in renal transplantation. Infectious etiologies, especially cytomegalovirus (CMV), are the most common causes, but side effects of immunosuppressive therapy are also frequent. Rarely, graft-versus-host disease, colon cancer, lymphoproliferative diseases, or “de novo” inflammatory bowel disease can present as diarrhea.1,–3,6
We report the case of a 50-year-old man admitted from the emergency unit with a 1-week history of abdominal pain on the right lower quadrant (RLQ) and bloody diarrhea. He had no other relevant symptoms like fever or weight loss. The patient had been renal transplanted 7 years ago and was receiving tacrolimus 1 mg id, mycofenolate mofetil (MMF) 1, 5 mg id, and prednisone 2, 5 mg id as immunosuppressive therapy. Chronic medication also included clopridogrel but there was no history of recent consumption of nonsteroidal antiinflammatory drugs (NSAIDs) or antibiotics. On admission he had pain without reboundness at RLQ on abdominal palpation. His physical examination was otherwise normal.
