Cord colitis syndrome is a diarrheal illness in recipients of

umbilical cord blood transplant Hematopoietic stem-cell transplantation (HSCT) is the transplantation of multipotent hematopoietic stem cells, usually derived from bone marrow, peripheral blood, or umbilical cord blood in order to replicate inside of a patient and to produce ...

. It causes a granulomatous inflammation of the upper and lower gastrointestinal tract and responds to antimicrobial treatment including metronidazole. It was first described in 2011. In 2013, a sequencing study identified a newly discovered bacterium, called '' Bradyrhizobium enterica'', in biopsy samples from two patients. That this bacterium is responsible for this syndrome can be suggested, but not yet confirmed. Subsequent studies showing that ''

Bradyrhizobium ''Bradyrhizobium'' is a genus of Gram-negative soil bacteria, many of which fix nitrogen. Nitrogen fixation is an important part of the nitrogen cycle. Plants cannot use atmospheric nitrogen (N2); they must use nitrogen compounds such as nitrat ...

'' species are common contaminants of laboratory kit reagents have thrown this connection into doubt.

Diagnosis

The presence of enterica in the colon-biopsy samples has been suggested to help in identification of patients with cord colitis. However, this may be an erroneous report confounded by contamination, and others have not detected ''

'' in cord colitis samples. Patients with cord colitis syndrome frequently have granulomatous inflammation on upper and lower GI tract biopsies, along with chronic injury characteristics like

distal colon The large intestine, also known as the large bowel, is the last part of the gastrointestinal tract and of the digestive system in tetrapods. Water is absorbed here and the remaining waste material is stored in the rectum as feces before being rem ...

Paneth cell metaplasia. Abdominal CT imaging typically reveals focal or diffuse thickening of the colonic wall, which is radiographically consistent with colitis.

Treatment

Cord colitis syndrome responds quickly to antibacterial treatment, which is typically a fluoroquinolone and metronidazole. Relapse is common following the discontinuation of antibacterial agents and may necessitate lengthy treatment courses.

References

External links

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