IDIOPATHIC, TREATMENT RESISTANT, GIANT OESOPHAGEAL ULCER IN A KIDNEY TRANSPLANT RECIPIENT.

Abstract

Giant oesophageal ulcers (GOU) are variable dened as ulcers larger than 10-20 millimeters. The initial reports were primarily in association with human immunodeciency virus (HIV). Since then they have been described in the setting of organ transplant including hematopoietic stem cell and lung transplantation. Association with kidney transplantation is rare and only three such cases have been described. The pathophysiology remains an enigma. We report a case of idiopathic, therapy unresponsive, GOU in a young male with Immunoglobulin A nephropathy (IgAN) related end stage kidney disease. Four months following the kidney transplantation he presented with graft dysfunction, reoccurrence of basic disease, odynophagia and weight loss. The endoscopic evaluation showed two GOU in the distal esophagus. The response to therapy was poor; it nally resolved spontaneously. Based on the temporal prole and the review of existing similar case reports, we believe, these GOU represent an extra-renal manifestation of IgAN.