J Korean Soc Transplant.  1999 Jun;13(1):177-181.

Herpes Simplex Esophagitis Following Cadaveric Renal Transplantation

• Seo SH
• Lee SS
• Park SB
• Kang YW
• Kim HC
• Cho WH
• Kim HT
• Park CH
• Kwon KY

Abstract

Herpes simplex esophagitis usually occurs in immunocompromised or severely debilitated patients. Odynophagia and dysphagia are major symptoms and the prognosis of immunocompromised patients is variable. We present the case of a cadeveric donor renal transplantation recipient who developed herpes simplex esophagitis shortly after anti-rejection therapy. A 43-years-old female had cadaveric renal transplantation and following treatment with cyclosporine, prednisolone, mycophenolate mofetile. Twelve months later, renal insufficieny and proteinuria were developed. Allograft kidney biopsy showed some evidence of acute rejection. She was treated with 3 successive days of intravenous methylpredinisolone (500 mg/d) therapy and continued tapering of steroids. Two weeks later, she had oral cavity ulceration, odynophagia, dysphagia, epigastric pain, and nausea. Esophagoscopy reveals multiple confluent ulceration in the whole part of esophagus and biopsies showed the epithelial cell were enlarged with prominent nuclei. Immunohistochemically, the epithelial cell were positive with a monoclonal antibody to herpes simplex virus type 1. Treatment was started on intravenous ayclovir and changed to oral agent for 10 days. After treatment, her symptoms and repeat endoscopic findings were improved.

Keyword

Renal transplantation; Herpes simplex; Herpetic esophagitis

MeSH Terms

Allografts
Biopsy
Cadaver*
Cyclosporine
Deglutition Disorders
Epithelial Cells
Esophagitis*
Esophagoscopy
Esophagus
Female
Herpes Simplex*
Herpesvirus 1, Human
Humans
Immunocompromised Host
Immunosuppression
Kidney
Kidney Transplantation*
Mouth
Nausea
Prednisolone
Prognosis
Proteinuria
Steroids
Tissue Donors
Ulcer
Cyclosporine
Prednisolone
Steroids