Graft-versus-host disease history and symptoms

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Graft-versus-host disease

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Shyam Patel [2]

Overview

The clinical presentation of GvHD can be quite diverse, depending on the types of organs affected and the severity of the immunologic reaction. Generally, gastrointestinal symptoms include diarrhea, abdominal pain, nausea and vomiting. Liver involvement presents as jaundice (yellow skin). Skin symptoms include a diffuse maculopapular rash. Pulmonary symptoms present as shortness of breath and cough.

History and Symptoms

Classically, acute graft-versus-host-disease is characterized by selective damage to the liver, skin and mucosa, and the gastrointestinal tract. Other graft-versus-host-disease target organs include the immune system (the hematopoietic system, such as the bone marrow and the thymus) itself, and the lungs in the form of idiopathic pneumonitis. Chronic graft-versus-host-disease also attacks the above organs, but over its long-term course can also causes damage to the connective tissue and exocrine glands.

  • Liver symptoms: Jaundice (yellowing of the skin). Acute liver GvHD is measured by the bilirubin level in acute patients.[1] The degree of bilirubin elevation determines the stage of liver GvHD.

References

  1. 1.0 1.1 McDonald GB (2016). "How I treat acute graft-versus-host disease of the gastrointestinal tract and the liver". Blood. 127 (12): 1544–50. doi:10.1182/blood-2015-10-612747. PMC 4807421. PMID 26729898.



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