Intra-arterial methylprednisolone for pediatric gastrointestinal post-transplant lymphoproliferative disorder.

This article discusses the use of intra-arterial methylprednisolone (IAM) as a treatment for pediatric gastrointestinal post-transplant lymphoproliferative disorder (PTLD). PTLD is a group of lymphoid disorders that occur in transplant recipients, particularly pediatric patients, and is characterized by uncontrolled B cell proliferation. The main treatment for PTLD is reduction of immunosuppression, but this can come with risks. IAM has been shown to be effective in controlling acute gastrointestinal bleeding in steroid-refractory transplant recipients, and this article describes the first use of IAM in a pediatric patient with PTLD. The patient experienced prompt cessation of bleeding and resolution of previous FDG uptake regions on a PET scan, although new regions of FDG uptake were observed. IAM was administered five times without complications. The article suggests that IAM can be a rapid and effective option for managing acute gastrointestinal bleeding in PTLD patients, particularly those on concurrent chemotherapy. Further research is needed to evaluate the utility of IAM in a larger pediatric population. [Extracted from the article]