Vitiligo following a combined liver-kidney transplant

Status: 
Ready to upload
Record number: 
1498
Adverse Occurrence type: 
MPHO Type: 
Estimated frequency: 
Case report
Time to detection: 
10 days
Alerting signals, symptoms, evidence of occurrence: 
Ten days after transplantation patient developed patchy areas of depigmentation on both feet.
Demonstration of imputability or root cause: 
Post transplant vitiligo after bone marrow transplantation has been reported and attributed to melanocyte destruction caused by the autoimmune reactions triggered by chronic graft versus host disease (GVHD) caused by donor lymphocytes. In this case, there is transient vitiligo that was treated with topical corticosteroids with no signs and symptoms of GVHD. Additional tests for presence of melanocyte-specific antibodies prior to transplantation in the recipient were negative. However, donor serum was not available for testing. Recipient of second kidney did not develop vitiligo.
Imputability grade: 
1 Possible
Groups audience: 
Suggest new keywords: 
Vitiligo
Live-kidney tranplantation
Reference attachment: 
Suggest references: 
Bradley, V, et al, 2009. Vitiligo following a combined liver-kidney transplant. 24:686-8
Note: 
Add (combined) liver-kidney in MPHO taxonomy (Evi)
Expert comments for publication: 
There is no definite evidence of post transplant vitiligo in this case to be caused by donor derived lymphocytes. While it is possible, post transplant vitiligo depends on the presence of melanocyte destroying T-cells and genetic predisposition.