Sustento-Reodica N, Ruiz P, Rogers A, Viciana A L, Conn H O, Tzakis A G
Department of Pathology, Jackson Memorial Hospital, Miami, Florida, USA.
Lancet. 1997 Mar 8;349(9053):688-91. doi: 10.1016/S0140-6736(96)09256-2.
Intestinal transplantation is used in patients with short-bowel syndrome after repeated resections for Crohn's disease. We report the apparent clinical recurrence of Crohn's disease in a transplanted intestine.
The patient, a 33-year-old Hispanic woman, underwent small-bowel transplantation in December, 1994. Immunosuppression with tacrolimus, methylprednisolone, bone-marrow infusions, and OKT3 was given. In July, 1995, the patient had recurrent abdominal symptoms. The histological diagnosis of Crohn's disease was established by the independent interpretations of four experienced gastrointestinal histopathologists.
The prompt appearance of this autoimmune disorder (within 6 months of transplantation), despite massive immunosuppression may provide important insights into the nature of Crohn's disease and of the recurrence of autoimmune disease during immunosuppression.
肠道移植用于因克罗恩病反复切除术后出现短肠综合征的患者。我们报告了移植肠段中克罗恩病明显的临床复发情况。
该患者为一名33岁的西班牙裔女性，于1994年12月接受小肠移植。给予他克莫司、甲泼尼龙、骨髓输注及OKT3进行免疫抑制治疗。1995年7月，患者出现反复的腹部症状。经四位经验丰富的胃肠组织病理学家独立解读，确诊为克罗恩病。
尽管进行了大量免疫抑制治疗，但这种自身免疫性疾病在移植后6个月内迅速出现，这可能为深入了解克罗恩病的本质以及免疫抑制期间自身免疫性疾病的复发提供重要线索。
