Differential Diagnosis for Transplant and Diarrhea
- Single Most Likely Diagnosis
- Gastrointestinal infection (e.g., Clostridioides difficile, norovirus): This is a common cause of diarrhea in transplant patients due to their immunocompromised state, which makes them more susceptible to infections.
- Other Likely Diagnoses
- Graft-versus-host disease (GVHD): This is a complication of allogeneic transplant where the donor's immune cells attack the recipient's tissues, including the gastrointestinal tract, leading to diarrhea.
- Medication side effect (e.g., mycophenolate, tacrolimus): Many immunosuppressive medications used in transplant patients can cause gastrointestinal side effects, including diarrhea.
- Opportunistic infections (e.g., CMV, EBV): Transplant patients are at risk for opportunistic infections due to their immunocompromised state, which can cause diarrhea.
- Do Not Miss Diagnoses
- Neutropenic colitis: This is a life-threatening condition that can occur in immunocompromised patients, characterized by inflammation of the colon, which can cause diarrhea, abdominal pain, and fever.
- Intestinal perforation: This is a surgical emergency that can occur in transplant patients, especially those with GVHD or opportunistic infections, which can cause diarrhea and abdominal pain.
- Rare Diagnoses
- Chronic graft-versus-host disease: This is a rare complication of allogeneic transplant where the donor's immune cells cause chronic inflammation of the recipient's tissues, including the gastrointestinal tract, leading to diarrhea.
- Post-transplant lymphoproliferative disorder (PTLD): This is a rare complication of transplant where the recipient develops lymphoma, which can cause diarrhea and other gastrointestinal symptoms.