Mucocutaneous complications in pediatric patients with liver transplantation

Öz

Background Liver transplant recipients can develop mucocutaneous lesions and the severity of these lesions can vary from benign to life-threatening conditions. The aim of this study was to investigate the frequency and clinical features of mucocutaneous complications after liver transplantation (LT) in pediatric patients. Methods Retrospectively, children who underwent LT and were detected with skin and mucosa lesions while being followed up in our Pediatric Gastroenterology outpatient clinic between June 2005 and July 2020 were evaluated. Age, gender, primary diagnosis, graft type, immunosuppression history and post-transplantation mucocutaneous complications were recorded from the patients’ file. Results Mucocutaneous lesions were observed in 16 (9 girls, 7 boys) of 37 patients after LT. Mean transplantation age ± SD was 1.96 ± 2.03 years and a mean follow-up period was 7.31 ± 2.69 years. The lesions due to viral infections were the most common dermatologic findings (n=7, 20.5%), followed by soft tissue infection (n=6), xerosis (n=5), urticaria (n=3), eczema (n=2), fissured tongue (n=3), acne vulgaris (n=3), tinea (n=2), alopecia areata (n=1), oral aphthae (n=1) and leukocytoclastic vasculitis (n=1). No premalignant or malignant lesion was detected in any patient. Conclusion Studies about mucocutaneous complications are limited in children after LT and these lesions are often caused by infections associated with the side effects of immunosuppressive treatment. Accordingly, a carefully dermatological examination should be performed during the follow-up of patients undergoing LT.

Anahtar Kelimeler

• liver transplantation
• immunosuppressive treatment
• mucocutaneous complications

Karaciğer nakilli çocuk hastalarda mukokutanöz komplikasyonlar

Öz

Amaç Karaciğer nakil hastalarında mukokutanöz lezyonlar yüzeysel cilt lezyonlarından yaşamı tehdit eden ciddi durumlara kadar değişkenlik göstermektedir. Bu çalışmada merkezimizde takip edilen karaciğer nakilli çocuk hastalarda gözlenen mukokutanöz komplikasyonların sıklığı ve klinik özellikleri değerlendirilmiştir. Yöntem Haziran 2005 - Temmuz 2020 tarihleri arasında çocuk gastroenteroloji polikliniğinde takip edilen karaciğer nakilli çocuk hastaların dosyaları retrospektif olarak incelendi. Yaş, cinsiyet, birincil tanı, greft tipi, immünosupresyon tedavisi ve transplantasyon sonrası mukokutanöz komplikasyonlar hasta dosyalarından kaydedildi. Bulgular Karaciğer nakli sonrası mukokutanöz lezyonlar 37 hastanın 16’sında (9 kız,7 erkek) gözlendi. Ortalama nakil yaşı ± SD 1.96 ± 2.03 yıl ve ortalama takip süresi 7.31 ± 2.69 yıldı. Dermatolojik bulgulardan en sık viral enfeksiyonlara bağlı cilt lezyonları (n=7, %20.5) görülürken, bunu yumuşak doku enfeksiyonu (n=6), kserozis (n=5), ürtiker (n=3), egzama (n=2), dilde yarıklanma (n=3), akne vulgaris (n=3), tinea (n=2), alopesi areata (n=1), oral aft (n=1) ve lökositoklastik vaskülit (n=1) takip etti. Premalign ve malign lezyon izlenmedi. Sonuç Karaciğer transplantasyonu sonrası çocuklarda mukokutanöz komplikasyonlarla ilgili çalışmalar sınırlıdır ve bu lezyonlar genellikle immünosupresif tedavinin yan etkileriyle ilişkili enfeksiyonlardan kaynaklanır. Bu nedenle nakil yapılan hastaların takibinde dikkatli bir dermatolojik muayene yapılmalıdır.

Anahtar Kelimeler

• karaciğer nakli
• immünsupresif tedavi
• mukokutanöz komplikasyonlar

Kaynakça

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