Identification of Cause of Posttransplant Cachexia by PCR

Nassim Kamar,Christine Segonds,Marion Grare,Lionel Rostaing,Olivier Cointault,Isabelle Rouquette,Marie-Laure Ranty-Quintyn,Joelle Guitard,Florence Fenollar,Sophie Edouard,Hubert Lepidi

doi:10.3201/eid1808.120309

Abstract

Identification of Cause of Posttransplant Cachexia by PCR

Highlights

Lymph node biopsy was repeated; results showed intramacrophagic coccobacilli tinted with Ziehl-Neelsen, Gram, and periodic acid–Schiff (PAS) stains
Screening results from quantitative real-time PCR for Tropheryma whipplei were negative for blood, saliva, stools, urine, and lymph nodes
Approach used to determine the cause of posttransplant cachexia in a patient*

Summary

Identification of Cause of Posttransplant Cachexia by PCR

To the Editor: A man, 56 years of age, was admitted to the hospital for epigastric pain, fever, and fatigue 8 years after a cardiac transplant. A mediastinal lymph node biopsy showed few AFB, suggesting M. tuberculosis or nontuberculous mycobacteria. Lymph node biopsy was repeated; results showed intramacrophagic coccobacilli tinted with Ziehl-Neelsen, Gram, and periodic acid–Schiff (PAS) stains. Screening results from quantitative real-time PCR (qPCR) for Tropheryma whipplei were negative for blood, saliva, stools, urine, and lymph nodes. Four weeks after cessation of antimicrobial drug treatment, a third lymph node biopsy was performed, in which the T. whipplei PCR result was positive. Results of T. whipplei PCRs targeting 2 different sequences were negative for the duodenal and lymph node biopsy specimens. These specimens were negative by PCR for 16S rRNA, Bartonella spp., and F. tularensis. Approach used to determine the cause of posttransplant cachexia in a patient*

Molecular tool to detect and identify Tropheryma whipplei

Murine Typhus in Drug Detoxification