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Acute graft versus host disease

GVH


Presentation

  • Rash was not present until late in their hospital course. Skin biopsies demonstrated mixed chimerism with pancreas donor DNA diagnostic of GVHD.[ncbi.nlm.nih.gov]
Hypoxemia
  • Our patient experienced dyspnea, worsening hypoxemia, and a progressive obstructive ventilatory defect 12 days after liver transplantation.[ncbi.nlm.nih.gov]
Mild Clinical Course
  • This study is a single case report of a non-HSCT candidate who developed skin aGVHD with mild clinical course after decitabine and G-PBSCs combination. The clinical course, chimerism, and aGVHD pathology studies are detailed.[ncbi.nlm.nih.gov]
Rectal Bleeding
  • Surgical management is an unusual approach, reserved for patients with intestinal occlusion, severe profuse rectal bleeding, or both.[ncbi.nlm.nih.gov]
Palmar Erythema
  • We report a post-transplant patient with clinical and histological acute graft-versus-host disease (GVHD) who concurrently developed acral erythema presenting as painful, well-defined and self-limiting palmar erythema with pustules.[ncbi.nlm.nih.gov]
Withdrawn
  • Unfortunately, the patient died after support was withdrawn because of total ablation of his bone marrow and multiorgan failure.[ncbi.nlm.nih.gov]

Workup

  • Complete workup at that time for infectious causes including cytomegalovirus, toxoplasma, and cryptococcus were negative. Further, the sedimentation rate, C-reactive protein, and thrombophilia screen were also normal or negative.[ajnr.org]
  • An infectious workup was negative. Liver function tests were normal, although ferritin was elevated to 27,232 ng/mL (reference range 30–450 ng/mL). A colon biopsy revealed scattered epithelial apoptosis with crypt destruction (Figure 1).[acgcasereports.gi.org]
  • […] biopsy in patients with persistent anorexia and vomiting Flexible sigmoidoscopy or colonoscopy with biopsy of sigmoid or colonic lesions in patients with diarrhea Liver biopsy (rarely done, usually only in patients with isolated hepatic findings) See Workup[emedicine.medscape.com]
Bilateral Pulmonary Infiltrate
  • We report a 54-year-old male who developed shortness of breath, cough, and bilateral pulmonary infiltrates in which the work-up failed to demonstrate an infectious etiology 165 days post-HLA-matched allogeneic peripheral blood stem cell transplant.[ncbi.nlm.nih.gov]
Hypertriglyceridemia
  • Asymptomatic hypertriglyceridemia was the most common therapy complication (69.2%), but treatment interruption was not needed. Thrombotic microangiopathy was rare (7.7%), but can be quickly solved by stopping everolimus and cyclosporine treatment.[ncbi.nlm.nih.gov]
Philadelphia Chromosome Positive
  • A 37-year-old woman with Philadelphia chromosome-positive acute lymphoblastic leukemia received allogeneic bone marrow transplants after first and second relapses from different HLA-identical brothers.[ncbi.nlm.nih.gov]
Demodex Folliculorum
  • Demodex folliculorum has been rarely implicated in the development of facial rashes in immunosuppressed patients, including BMT recipients.[ncbi.nlm.nih.gov]

Treatment

  • METHODS: To evaluate the therapeutic potential of MSCs in the treatment of steroid-refractory acute GvHD, we conducted a systematic literature search.[ncbi.nlm.nih.gov]

Prognosis

  • With a well-developed strategy of acute graft-versus-host disease (aGVHD) prophylaxis, the prognosis of allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients who develop aGVHD has improved considerably.[ncbi.nlm.nih.gov]

Etiology

  • Its diagnosis requires work-up to rule out an infectious etiology and a biopsy to confirm histology.[ncbi.nlm.nih.gov]
  • , response to treatment, and treatment-related mortality in acute GVHD. 3,4 For example, Reg3α may be useful in establishing the etiology of post-transplant diarrhea.[hematology.org]
  • All dysfunction should be scored on the chronic GVHD assessment sheet with other etiologies noted as appropriate.[bloodjournal.org]
  • Infectious etiologies must always be ruled out. Signs Ocular GVHD is associated with meibomian gland obstruction, anterior and posterior blepharitis. There is often associated scaring of the lacrimal gland leading to decreased tear production.[eyewiki.aao.org]

Epidemiology

  • 2 Department of Hematology, Hokkaido University Graduate School of Medicine, Sapporo, Japan. 3 Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan. 4 Department of Clinical Trial and Clinical Epidemiology[ncbi.nlm.nih.gov]
  • This COST Action will serve as a platform for industry, clinical teams and researchers from numerous disciplines, including bioinformatics, immunology, epidemiology, genetics and cell biology, to enable the dissemination of integrated clinical and laboratory[cost.eu]
  • A close relationship exists between the development of chronic GVHD and a helpful graft-versus-tumor/leukemia effect. [3] Epidemiology Frequency United States Autologous GVHD occasionally occurs after autologous or syngeneic HCT (7-10%).[emedicine.medscape.com]
  • Epidemiology In 2003, 13,700 allogeneic HSCTs were reported to the Center for International Blood and Marrow Transplant Research (CIBMTR). The incidence of grade II-IV acute GVHD is roughly 35%–50%.[ojrd.biomedcentral.com]
Sex distribution
Age distribution

Pathophysiology

  • Here we discuss the aGVHD pathophysiology initiated by multiple signals that cause alloreactive T-cell activation.[ncbi.nlm.nih.gov]
  • In this review, we will discuss the pathophysiology of aGVHD along with the preventative and treatment strategies.[dovepress.com]

Prevention

  • EXPERT OPINION: A new understanding of the involvement of cytokines, intracellular signaling pathways, epigenetics and immunoregulatory cells in GVHD pathogenesis will lead to new standards for aGVHD prophylaxis allowing better prevention of severe aGVHD[ncbi.nlm.nih.gov]
  • In rheumatoid arthritis, abatacept inhibits T-cell activation and prevents the chain of events that lead to debilitating joint inflammation.[seattlechildrens.org]
  • ) to prevent additional risks of infection from the added immunosuppressants used to prevent and treat GVHD.[lls.org]
  • It has also given us a model that allows testing of various strategies for prevention and treatment.[dovepress.com]

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