A 45-year-old male recipient of a renal allograft was
admitted because of a giant oesophageal ulcer coinciding
with leucopoenia. An extensive workup revealed no
explanation for the ulcer and leucopoenia. Our final
diagnosis by exclusion was an idiopathic giant oesophageal ulcer and late-onset neutropenia as consequences of rituximab induction therapy given during the transplant procedure. The patient fully recovered after treatment with prednisone. However, after four months, the ulcer and leucopoenia recurred and again successfully responded to treatment with prednisone.