Yousif Muhammad, Abbas Zaigham, Mubarak Muhammad
Department of Gastroenterology and Histopathology, Sindh Institute of Urology and Transplantation, Karachi.
J Pak Med Assoc. 2006 Aug;56(8):383-5.
Malakoplakia (MK) is a rare, chronic inflammatory disorder with characteristic morphologic features. It most commonly involves urogenital organs but can affect any organ system in the body. Gastrointestinal tract is the second common site of involvement. It commonly occurs in nontransplant patients but transplant patients are also vulnerable to it. We present a case report of a forty year old male renal transplant patient, who received a kidney from his brother with 1 haplotype and 4 antigen match. He was on regular post transplant follow up with stable graft function. Fifteen months post transplant he presented with the complaint of painful defecation, a swelling in the perianal region and inability to sit down properly. Biopsy examination showed malakoplakia with characteristic Michaelis-Gutmann bodies. Culture of the tissue grew E Coli. Immunosuppression therapy was curtailed and patient was started on ciprofloxacin 500mg OD for 6 months. The lesions regressed completely after six months of the above therapy and the patient became completely symptoms free.
软斑病（MK）是一种罕见的慢性炎症性疾病，具有特征性形态学特征。它最常累及泌尿生殖器官，但可影响身体的任何器官系统。胃肠道是第二个常见受累部位。它常见于非移植患者，但移植患者也易患此病。我们报告一例40岁男性肾移植患者的病例，该患者接受了来自其兄弟的1个单倍型和4个抗原匹配的肾脏。他接受定期的移植后随访，移植肾功能稳定。移植后15个月，他出现排便疼痛、肛周肿胀和无法正常坐下的症状。活检检查显示为伴有特征性米氏小体的软斑病。组织培养培养出大肠杆菌。减少免疫抑制治疗，并开始让患者口服500mg环丙沙星，每日一次，持续6个月。经过上述治疗6个月后，病变完全消退，患者症状完全消失。
