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Pathology · single question

A transplant patient on immunosuppressants develops oral mucosal lesions. What is the MOST likely cause?

  1. Graft-versus-host disease affecting oral tissue
  2. Drug side effect / medication-induced reaction
  3. Viral reactivation (EBV or CMV)
  4. Normal wound healing variation
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Correct answer: B. Drug side effect / medication-induced reaction

Transplant patients are on multiple immunosuppressive medications (cyclosporine, tacrolimus, mycophenolate, corticosteroids). Drug reactions are the most common cause of oral lesions in this population. Classic example: cyclosporine-induced gingival hyperplasia (overgrowth). Always review the medication list when a transplant patient presents with oral lesions.
  • A. ❌ Graft-versus-host disease occurs in BONE MARROW (allogeneic) transplants — not in solid organ transplants.
  • B. ✅ Drug side effect — most common cause of oral lesions in solid organ transplant patients on multiple immunosuppressants.
  • C. ❌ Viral reactivation (EBV/CMV) can occur but drug reactions are more commonly the presenting cause.
  • D. ❌ Normal healing variation does not explain new mucosal lesions appearing post-transplant.

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