A New White Oral Lesion in a Pediatric Heart Transplant Recipient Following Campath™ Therapy: Expanding the Differential Diagnosis

Patients who have undergone organ transplantation can present with a variety of oral lesions that appear to be related either directly to their medication or arise as a consequence of drug-induced immunosuppression. Such lesions are commonly caused by fungal and viral agents. Campath™ (Alemtuzumab, a B and T cell depleting monoclonal antibody against CD-52) is used in cardiac transplant patients with refractory rejection. The profound T-cell suppression that occurs with Campath™ therapy broadens the differential diagnosis for such lesions to include potentially severe etiologies typically considered in patients with HIV. This report reviews the causes of oral lesions in immunosuppressed patients, specifically in the context of Campath™ therapy and describes an unusual case of a benign cause of a new oral lesion, chronic biting of the oral mucosa or Morsicato mucosae in a pediatric heart transplant recipient who was treated with Campath™ for cardiac allograft rejection.