{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,11,1]],"date-time":"2023-11-01T13:16:28Z","timestamp":1698844588322},"reference-count":19,"publisher":"Akademiai Kiado Zrt.","issue":"18","license":[{"start":{"date-parts":[[2021,5,2]],"date-time":"2021-05-02T00:00:00Z","timestamp":1619913600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["akjournals.com"],"crossmark-restriction":true},"short-container-title":["OH"],"published-print":{"date-parts":[[2021,5,2]]},"abstract":"<jats:p><jats:bold>\u00d6sszefoglal\u00f3.<\/jats:bold> A gyullad\u00e1sos b\u00e9lbetegs\u00e9g (inflammatory bowel disease,\n                    IBD) incidenci\u00e1ja folyamatosan n\u0151, etiol\u00f3gi\u00e1ja egyel\u0151re ismeretlen. Kezel\u00e9s\u00e9ben\n                    gyakran alkalmazunk immunszuppressz\u00edv, illetve immunmodul\u00e1ns szereket. Egyes\n                    esetekben azonban szolidszerv-transzplant\u00e1ci\u00f3t k\u00f6vet\u0151en, folyamatos\n                    immunszuppressz\u00edv kezel\u00e9s mellett is megfigyelhet\u0151 <jats:italic>de novo<\/jats:italic> IBD\n                    kialakul\u00e1sa. C\u00e9lunk az volt, hogy Klinik\u00e1nk beteganyag\u00e1b\u00f3l \u00f6sszes\u00edts\u00fck azon\n                    eseteket, amelyekben szolid szerv (m\u00e1j, vese, t\u00fcd\u0151) transzplant\u00e1ci\u00f3j\u00e1t k\u00f6vet\u0151en\n                        <jats:italic>de novo<\/jats:italic> IBD alakult ki. A transzplant\u00e1ci\u00f3t megel\u0151z\u0151en\n                    szklerotiz\u00e1l\u00f3 cholangitis miatt gondozott betegeket kiz\u00e1rtuk. A Klinik\u00e1nkon\n                    gondozott, szolid szerv transzplant\u00e1ci\u00f3j\u00e1n (179 m\u00e1j, 197 vese, 29 t\u00fcd\u0151) \u00e1tesett\n                    betegek k\u00f6z\u00fcl 4 (2 m\u00e1j- \u00e9s 2 vesetranszplant\u00e1lt) gyermekn\u00e9l alakult ki\n                        <jats:italic>de novo<\/jats:italic> IBD. A transzplant\u00e1ci\u00f3hoz vezet\u0151 alapbetegs\u00e9gek\n                    biliaris atresia, polycyst\u00e1s vese \u00e9s Denys\u2013Drash-szindr\u00f3ma voltak. A\n                    transzplant\u00e1ci\u00f3t k\u00f6vet\u0151 immunszuppressz\u00edv ter\u00e1pia mind a 4 esetben tartalmazott\n                    sziszt\u00e9m\u00e1sszteroid- \u00e9s takrolimuszkezel\u00e9st, emellett 3 esetben\n                    mikofenol\u00e1t-mofetil (MMF)-ter\u00e1pi\u00e1t is. A kivizsg\u00e1l\u00e1st indik\u00e1l\u00f3 f\u0151bb t\u00fcnetek a\n                    haematochesia, hasmen\u00e9s, f\u00e1rad\u00e9konys\u00e1g \u00e9s fogy\u00e1s voltak. A csal\u00e1di anamn\u00e9zis 1\n                    esetben volt pozit\u00edv. A <jats:italic>de novo<\/jats:italic> IBD diagn\u00f3zis\u00e1nak fel\u00e1ll\u00edt\u00e1s\u00e1t\n                    k\u00f6vet\u0151en mind a 4 betegn\u00e9l az addigi immunszuppresszi\u00f3s ter\u00e1pia m\u00f3dos\u00edt\u00e1sra\n                    ker\u00fclt. \u00d6sszess\u00e9g\u00e9ben elmondhat\u00f3, hogy a szolidszerv-transzplant\u00e1ci\u00f3t k\u00f6vet\u0151\n                        <jats:italic>de novo<\/jats:italic> IBD kialakul\u00e1sa ritka, etiol\u00f3gi\u00e1ja tiszt\u00e1zatlan. Az\n                    irodalom felveti az alkalmazott immunszuppressz\u00edv szerek (takrolimusz \u00e9s MMF),\n                    illetve infekci\u00f3k etiol\u00f3giai szerep\u00e9t, de az is felmer\u00fcl, hogy a <jats:italic>de\n                        novo<\/jats:italic> IBD olyan \u00f6n\u00e1ll\u00f3 entit\u00e1s, mely elk\u00fcl\u00f6n\u00fcl a klasszikus IBD\n                    kateg\u00f3ri\u00e1it\u00f3l. Klinikai szempontb\u00f3l fontos a t\u00fcnetek h\u00e1tter\u00e9ben \u00e1ll\u00f3 betegs\u00e9g\n                    tiszt\u00e1z\u00e1sa, hiszen a prezent\u00e1ci\u00f3s t\u00fcneteknek megfelel\u0151, a\n                    differenci\u00e1ldiagnosztika sor\u00e1n felmer\u00fcl\u0151 egy\u00e9b betegs\u00e9gek ter\u00e1pi\u00e1ja mer\u0151ben\n                    elt\u00e9r. A megfelel\u0151 ter\u00e1pia hozz\u00e1j\u00e1rulhat a transzplant\u00e1lt betegek morbidit\u00e1s\u00e1nak\n                    \u00e9s mortalit\u00e1s\u00e1nak cs\u00f6kkent\u00e9s\u00e9hez. Orv Hetil. 2021; 162(18): 720\u2013726.<\/jats:p>\n                <jats:p><jats:bold>Summary.<\/jats:bold> The incidence of inflammatory bowel disease (IBD) is\n                    increasing, however, the aetiology is still unknown. The therapy consists of\n                    immunosuppressants and immunomodulators. In some cases, despite the continuous\n                    immunosuppressant therapy, <jats:italic>de novo<\/jats:italic> IBD develops. Our aim was to\n                    evaluate patients diagnosed with <jats:italic>de novo<\/jats:italic> IBD after solid organ\n                    (liver, kidney, or lung) transplantation. Patients treated with sclerosing\n                    cholangitis prior to liver transplantation were excluded. 4 patients (two kidney\n                    and two liver transplants) were diagnosed with <jats:italic>de novo<\/jats:italic> IBD. The\n                    underlying diseases leading to transplantation were biliary atresia, polycystic\n                    kidney, and Denys\u2013Drash syndrome. All patients received systemic steroid and\n                    tacrolimus treatment, and 3 patients (2 kidney and 1 liver transplant) also\n                    received mycophenolate mofetil (MMF). The main symptoms indicative of <jats:italic>de\n                        novo<\/jats:italic> IBD were haematochezia, diarrhoea, fatigue, and weight loss.\n                    Family history for IBD was positive in 1 case. Following the diagnosis of IBD,\n                    immunosuppressive therapy was modified. Overall, the development of <jats:italic>de\n                        novo<\/jats:italic> IBD following solid organ transplantation is quite rare, and\n                    its aetiology is unknown. According to the literature, immunosuppressants\n                    (tacrolimus and MMF) and infections play a role in the pathomechanism, but it\n                    seems that <jats:italic>de novo<\/jats:italic> IBD is a separate entity from the classical\n                    IBD categories. From a clinical point of view, it is important to elucidate the\n                    underlying disease of the symptoms, as the treatment of other diseases that\n                    arise during differential diagnosis according to the presentation symptoms is\n                    very different. Appropriate therapy can help reduce morbidity and mortality in\n                    transplant patients. Orv Hetil. 2021; 162(18): 720\u2013726.<\/jats:p>","DOI":"10.1556\/650.2021.32070","type":"journal-article","created":{"date-parts":[[2021,5,27]],"date-time":"2021-05-27T12:26:12Z","timestamp":1622118372000},"page":"720-726","update-policy":"http:\/\/dx.doi.org\/10.1556\/policypage.crossmark.crossref.1","source":"Crossref","is-referenced-by-count":1,"title":["Szolidszerv-transzplant\u00e1ci\u00f3 ut\u00e1n kialakul\u00f3 de novo gyullad\u00e1sos b\u00e9lbetegs\u00e9g gyermekkorban"],"prefix":"10.1556","volume":"162","author":[{"given":"Kriszta Katinka","family":"Boros","sequence":"first","affiliation":[{"name":"1 Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, I. Gyermekgy\u00f3gy\u00e1szati Klinika, Budapest, B\u00f3kay J. u. 53., 1083"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kata","family":"Kelen","sequence":"additional","affiliation":[{"name":"1 Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, I. Gyermekgy\u00f3gy\u00e1szati Klinika, Budapest, B\u00f3kay J. u. 53., 1083"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gy\u00f6rgy","family":"Reusz","sequence":"additional","affiliation":[{"name":"1 Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, I. Gyermekgy\u00f3gy\u00e1szati Klinika, Budapest, B\u00f3kay J. u. 53., 1083"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P\u00e9ter","family":"Sallay","sequence":"additional","affiliation":[{"name":"1 Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, I. Gyermekgy\u00f3gy\u00e1szati Klinika, Budapest, B\u00f3kay J. u. 53., 1083"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Attila","family":"Szab\u00f3","sequence":"additional","affiliation":[{"name":"1 Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, I. Gyermekgy\u00f3gy\u00e1szati Klinika, Budapest, B\u00f3kay J. u. 53., 1083"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antal","family":"Dezs\u0151fi","sequence":"additional","affiliation":[{"name":"1 Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, I. Gyermekgy\u00f3gy\u00e1szati Klinika, Budapest, B\u00f3kay J. u. 53., 1083"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"425","reference":[{"key":"ref0","doi-asserted-by":"publisher","first-page":"91","DOI":"10.3748\/wjg.v20.i1.91","article-title":"Inflammatory bowel disease: pathogenesis","volume":"20","author":"Zhang YZ","year":"2014","unstructured":"1 Zhang YZ, Li YY. Inflammatory bowel disease: pathogenesis. World J Gastroenterol. 2014; 20: 91-99.","journal-title":"World J Gastroenterol"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"2 Verdonk RC, Haagsma EB, van den Berg AP, et al. 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