Hypertrophic osteoarthropathy in intestinal transplant recipients

Margaret M. McGuire, Shadpour Demehri, Heung Bae Kim, Daniel Kamin

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


We report 3 patients with periosteal new bone formation consistent with hypertrophic osteoarthropathy (HOA), in the context of intestinal allograft rejection. Patient 1 developed thick periosteal new bone formation of the right arm during a prolonged episode of intestinal acute cellular rejection (ACR) 2 months posttransplant. Patient 2 developed ankle pain and swelling during an episode of severe ACR. Plain films showed periosteal new bone formation of the left ankle. In patient 3, the right wrist became swollen during an episode of moderate ACR, whereas plain films demonstrated mild periosteal reaction. Patients 2 and 3 had resolution of their symptoms once the ACR resolved with treatment. This is the first case series of HOA occurring in association with intestinal ACR. We speculate that an immune-mediated process is responsible for the bone disease. Further inquiry will help establish if HOA is related to transplant status, intestinal inflammation, or allograft rejection in general.

Original languageEnglish (US)
Pages (from-to)e19-e22
JournalJournal of pediatric surgery
Issue number11
StatePublished - Nov 1 2010
Externally publishedYes


  • Acute cellular rejection
  • Hypertrophic osteoarthropathy
  • Intestinal transplantation

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health


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