Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 6, 2019; 7(19): 3074-3081
Published online Oct 6, 2019. doi: 10.12998/wjcc.v7.i19.3074
Hair regrowth following fecal microbiota transplantation in an elderly patient with alopecia areata: A case report and review of the literature
Wen-Rui Xie, Xiao-Ya Yang, Harry Hua-Xiang Xia, Li-Hao Wu, Xing-Xiang He
Wen-Rui Xie, Harry Hua-Xiang Xia, Li-Hao Wu, Xing-Xiang He, Department of Gastroenterology, the First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou 510080, Guangdong Province, China
Xiao-Ya Yang, Department of Physiology, Guangzhou Health Sciences College, Guangzhou 510180, Guangdong Province, China
Author contributions: Xie WR and He XX designed the report; Xie WR and Wu LH collected the patient’s clinical data; Xie WR and Yang XY analyzed the data and wrote the manuscript; Xia HHX provided professional advice and revised the manuscript.
Supported by Traditional Chinese Medicine Bureau of Guangdong Province, No. 20151283; and Department of Education of Guangdong Province, No. 2014KQNCX113 and No. 2018GKTSCX033.
Informed consent statement: The patient involved in this study gave his written informed consent authorizing use and disclosure of his protected health information.
Conflict-of-interest statement: All the authors have no conflicts of interest to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2013), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non-Commercial (CC BY- NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Xing-Xiang He, MD, PhD, Chief Doctor, Professor, Department of Gastroenterology, the First Affiliated Hospital of Guangdong Pharmaceutical University, No. 19, Nonglinxia Road, Yuexiu District, Guangzhou 510080, Guangdong Province, China. hexingxiang@gdpu.edu.cn
Telephone: +86-20-61321167 Fax: +86-20-61339399
Received: May 26, 2019
Peer-review started: May 27, 2019
First decision: August 1, 2019
Revised: August 25, 2019
Accepted: September 11, 2019
Article in press: September 11, 2019
Published online: October 6, 2019
Processing time: 127 Days and 4 Hours
Abstract
BACKGROUND

Alopecia areata is a hair loss disease associated with genetics, autoimmunity, and other factors. There is an intriguing link between alopecia areata and gut dysbiosis. Fecal microbiota transplantation (FMT) has been recommended to treat Clostridium difficile (previously known as Clostridioides difficile) infection, and has also shown potentials in the treatment of inflammatory bowel disease, irritable bowel syndrome, and non-alcohol fatty liver disease.

CASE SUMMARY

An 86-year-old man, with a history of sigmoid colon carcinoma, suffered from recurrent abdominal pain and distension, and diarrhea for six months, with inappetence. At admission, he was also diagnosed with depression. Upon physical examination, the patient presented with a 1.5 cm × 2.0 cm alopecia areata on his right occiput. Due to the negative results of laboratory testing, capsule endoscopy, and colonoscopy, the patient was diagnosed with noninfectious diarrhea, depressive disorder, and patchy alopecia areata. Considering that noninfectious diarrhea in the elderly patient was mainly caused by gut dysbiosis, he was given six rounds of FMT. His diarrhea improved remarkably one month after FMT, with improved appetite and disappearance of abdominal pain, distension, and depressive symptoms. Surprisingly, he reported new hair growth on the affected region of his scalp, with some of his white hair gradually turning to black, without taking any other therapies for alopecia areata before and after FMT.

CONCLUSION

FMT might act as a potential therapy for patients who suffer from alopecia areata. Large and well-designed studies are required to confirm the role of FMT in alopecia areata.

Keywords: Fecal microbiota transplantation; Alopecia areata; Gut microbiota; Autoimmune disease; Psychopathogenesis; Case report

Core tip: Fecal microbiota transplantation (FMT) has been recommended to treat Clostridium difficile (previously known as Clostridioides difficile) infection, and has shown its potential role in the treatment of inflammatory bowel disease, irritable bowel syndrome, liver disease, and other disorders. This case report describes an elderly Chinese patient with alopecia areata who experienced restored hair growth and pigmentation after receiving FMT for his noninfectious diarrhea. Concurrently, the senile plaques on his face disappeared and his depressive symptoms improved.