肾移植受者的炎症性肠病:病例系列和文献综述

Prilozi Pub Date : 2022-03-01 DOI:10.2478/prilozi-2022-0006
Jakob Vrus, N. Jukić
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引用次数: 0

摘要

炎症性肠病是影响胃肠道并产生多种肠外表现的自身免疫性疾病。肾脏是其肠外活动的罕见靶器官,但如果受到影响,肾功能可能恶化为终末期肾病,这只能通过器官移植来治愈。肾结石是IBD患者最常见的病理性肾脏表现,其次是小管间质性肾炎、肾小球肾炎等肾脏病理。肝脏是IBD患者(原发性硬化性胆管炎和自身免疫性肝炎)中最常见的移植器官,迄今为止,关于这一特定患者群体中肾功能不全、肾移植、移植后IBD病程以及移植排斥或感染等进一步并发症的文献很少。在严格的移植后免疫抑制的背景下,新生IBD是一个矛盾的实体。在本病例系列中,我们报告了三名有IBD病史的肾移植患者和一名在已故供体器官移植后发生新发克罗恩病的患者。
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Inflammatory Bowel Diseases in Renal Transplantat Recipients: A Case Series and Review of the Literature
Abstract Inflammatory bowel diseases are autoimmune disorders affecting the gastrointestinal tract and producing a wide variety of extraintestinal manifestations. Kidneys are a rare target organ of their extraintestinal activity, but if affected, renal function could deteriorate to end-stage kidney disease, which is curable only by organ transplantation. Renal calculi are the most common pathological kidney manifestation in IBD patients, followed by tubulointerstitial nephritis, glomerulonephritis, and other kidney pathologies. The liver is the most commonly transplanted organ in IBD patients (primary sclerosing cholangitis and autoimmune hepatitis), and a scarcity of literature on kidney recipients is present to date regarding the incidence of renal insufficiency, kidney transplantations, post-transplant IBD course and further complications such as graft rejection or infections in this specific group of patients. De novo IBD is a paradoxical entity in the setting of rigorous post-transplant immunosuppression. In this case series, we present three patients who underwent kidney transplantation with a history of an IBD and one patient who developed de novo Crohn’s disease after the deceased donor organ transplant was performed.
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