Differential Diagnosis for Patient with Diarrhea, Nausea, Vomiting, and History of Liver Transplant

• Single Most Likely Diagnosis
  • Gastroenteritis: This is a common cause of diarrhea, nausea, and vomiting in the general population, and a patient with a history of liver transplant may be more susceptible due to immunosuppression.
• Other Likely Diagnoses
  • Medication side effects (e.g., mycophenolate mofetil, tacrolimus): These immunosuppressive medications, commonly used in liver transplant patients, can cause gastrointestinal side effects.
  • Infection (e.g., CMV, EBV): Immunocompromised patients are at higher risk for opportunistic infections, which can cause gastrointestinal symptoms.
  • Rejection or graft dysfunction: Although less common, graft dysfunction or rejection can cause a range of symptoms, including gastrointestinal disturbances.
• Do Not Miss Diagnoses
  • Graft-versus-host disease (GVHD): A potentially life-threatening complication that can occur after liver transplant, especially if the patient has received blood products or has a history of hematopoietic stem cell transplant.
  • Sepsis: Immunocompromised patients are at higher risk for sepsis, which can present with nonspecific symptoms, including gastrointestinal disturbances.
  • Hepatic artery thrombosis: A rare but potentially life-threatening complication of liver transplant that can cause graft dysfunction and necessitate urgent intervention.
• Rare Diagnoses
  • Post-transplant lymphoproliferative disorder (PTLD): A rare but potentially life-threatening complication of immunosuppression, which can cause a range of symptoms, including gastrointestinal disturbances.
  • Recurrent primary liver disease (e.g., primary sclerosing cholangitis): In some cases, the underlying disease that led to liver transplant can recur, causing graft dysfunction and gastrointestinal symptoms.