Bone marrow engraftment and associated dermatologic sequelae in a three-yr-old after liver transplantation

Johanna Sheu, Arturo P. Saavedra, Barbara A. Degar, Christine N. Duncan, Rima Fawaz, Jennifer K. Tan, Birgitta A. Schmidt, Heung B. Kim, Jennifer T. Huang

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

We present a case of a three-yr-old child with a history of multisystem Langerhans cell histiocytosis treated with systemic chemotherapy, who developed progressive liver failure and received an orthotopic split liver transplant while continuing on chemotherapy. One month following transplant, he developed acute graft-vs.-host disease of the skin and gastrointestinal tract. Peripheral blood chimerism studies post-transplant demonstrated an increasing predominance of donor lymphocytes and granulocytes. Shortly after, the patient developed vitiligo, and two yr after transplantation, the patient developed skin manifestations of psoriasis. We discuss and review the current literature, which demonstrates that chimerism following liver transplantation is rare and in our patient may be related to his profound immunosuppression around the time of liver transplant as well the development of acute graft-versus-host disease. While autoimmune disease can occur after solid organ and stem cell transplant, our patient developed skin manifestations of autoimmunity after liver transplantation, which is also rarely described.

Original languageEnglish
Pages (from-to)E41-E46
JournalPediatric Transplantation
Volume19
Issue number2
DOIs
StatePublished - Mar 1 2015
Externally publishedYes

Keywords

  • Langerhans cell histiocytosis
  • autoimmune
  • bone marrow engraftment
  • chimerism
  • liver transplantation
  • post-transplant

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