RECURRENT CROHNS-DISEASE IN TRANSPLANTED BOWEL

Background Intestinal transplantation is used in patients with short-b owel syndrome after repeated resections for Crohn's disease. We report the apparent clinical recurrence of Crohn's disease in a transplanted intestine. Methods and findings The patient, a 33-year-old Hispanic w oman, underwent small-bowel transplantation in December, 1994. Immunos uppression with tacrolimus, methylprednisolone, bone-marrow infusions, and OKT3 was given. In July, 1995, the patient had recurrent abdomina l symptoms. The histological diagnosis of Crohn's disease was establis hed by the independent interpretations of four experienced gastrointes tinal histopathologists. Interpretation The prompt appearance of this autoimmune disorder (within 6 months of transplantation), despite mass ive immunosuppression may; provide important insights into the nature of Crohn's disease and of the recurrence of autoimmune disease during immunosuppression.