Eosinophilic Appendicitis Attributable to Strongyloides Infection in a Pediatric Renal Transplant Patient
Year: 2012
Type: article
Study design: Case Report
Abstract: The patient was born in a town near Bogotá, Colombia and was adopted in the United States at 2 years of age. At the time of adoption, there was a suspicion of renal disease with failure to thrive. Within a year of arriving in Alabama, she was diagnosed with hypoplastic-dysplastic syndrome. Her renal disease resulted in dialysis at age 16, and she received a living unrelated renal transplant from her adoptive mother at age 18. She was treated with an immunosuppressive regimen that included tacrolimus, mycophenolate, and prednisone. Her immediate posttransplant course was notable only for complaints of mild diarrhea that worsened when her regimen changed from tacrolimus to sirolimus in the 8th month after transplant for a research protocol. At 9 months posttransplant, she developed severe, constant, right lower quadrant abdominal pain. Her diarrhea worsened and she developed headaches, but she denied having fever, cough, difficulty breathing, vomiting, or bloody stools. A computerized tomography scan showed findings associated with appendicitis, which prompted appendectomy. Pathologic examination of the specimen identified intense transmural eosinophilic infiltration of the appendiceal wall consistent with eosinophilic appendicitis (Figure 1). Biopsies of the terminal ileum, cecum, and colon at the hepatic flexure also revealed eosinophilic infiltrates. No parasitic forms were found in any of the tissue samples by direct visualization. A peripheral eosinophilia of up to 9.5%was documented, and a stool test was negative for ova and parasites (O&P).
DOI: 10.1093/jpids/pis090
Authors: B. Rha, D. R. Kelly, M. Shimamura
Institution: University of Alabama at Birmingham
Language: English
Subfield: Rheumatology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2096505189