Abstract
Endoscopic appearance of the gastrointestinal tract of a patient with severe hemorrhagic enteric graft-vs.-host disease (GVHD) is presented. A 29-year-old man with chronic myelogenous leukemia suffered from severe enteric GVHD after allogeneic bone marrow transplantation. Endoscopy showed hemorrhagic ulceration of the upper jejunum, terminal ileum, and colon at the onset of melena. Sections of biopsies were compatible with acute GVHD. Repeat endoscopy showed gradual healing of the lesions after steroid pulse and antilymphocyte globulin therapy, but the patient died of cytomegalovirus pneumonitis 14 months later. Autopsy revealed submucosal fibrosis of the small intestine and colon.
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References
Sullivan KM. Clinical bone marrow transplantation. New York: Churchill Livingstone, 1983:91.
McDonald GB, Shulman HM, Sullivan KM, Spencer GD. Intestinal and hepatic complications of human bone marrow transplantation. Part I. Gastroenterology 1986;90:460–77.
Weisdorf SA, Salati LM, Longsdorf JA, Ramsay NKC, Sharp HL. Graft-versus-host disease of the intestine: a protein losing enteropathy characterized by fecal antitrypsin. Gastroenterology 1983;85:1076–81.
Maile CW, Frick MP, Crass JR, Snover DC, Weisdorf SA, Kersey JH. The plain abdominal radiograph in acute gastrointestinal graft-vs.-host disease. AJR 1985;145:289–92.
Spencer DG, Shulman HM, Myerson D, Thomas ED, McDonald GB. Diffuse intestinal ulceration after marrow transplantation: a clinicopathologic study of 13 patients. Hum Pathol 1986;17:621–33.
Snover DC, Weisdorf SA, Vercellotti GM, Rank B, Hutton S, McGlave P. A histopathologic study of gastric and small intestinal graft-versus-host disease following allogeneic bone marrow transplantation. Hum Pathol 1985;16:387–92.
Epstein RJ, McDonald GB, Sale GE, Shuleman HM, Thomas ED. The diagnostic accuracy of the rectal biopsy in acute graft-versus-host disease: a prospective study of thirteen patients. Gastroenterology 1980;78:764–71.
Spencer GD, Hackman RC, McDonald GB, et al. A prospective study of unexplained nausea and vomiting after marrow transplantation. Transplantation 1986;42:602–7.
Strayer DS, Phillips GB, Barker KH, Winokur T, DeSchryver-Kecskemeti K. Gastric cytomegalovirus infection in bone marrow transplantation patients: an induction of generalized disease. Cancer 1981;15:1478–83.
Meiselman MS, Cello LP, Margaretten W. Cytomegalovirus colitis: report of the clinical, endoscopic, and pathologic findings in two patients with the acquired immune deficiency syndrome. Gastroenterology 1985;88:171–5.
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Saito, H., Oshimi, K., Nagasako, K. et al. Endoscopic appearance of the colon and small intestine of a patient with hemorrhagic enteric graft-vs.-host disease. Dis Colon Rectum 33, 695–697 (1990). https://doi.org/10.1007/BF02150747
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DOI: https://doi.org/10.1007/BF02150747