Graft-versus-host disease history and symptoms: Difference between revisions

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*Pulmonary symptoms: [[Shortness of breath]] and [[cough]]. Severe [[pneumonitis]] can result in [[Respiratory failure|respiratory failur]]<nowiki/>e requiring [[Tracheal intubation|intubation]].
*Pulmonary symptoms: [[Shortness of breath]] and [[cough]]. Severe [[pneumonitis]] can result in [[Respiratory failure|respiratory failur]]<nowiki/>e requiring [[Tracheal intubation|intubation]].
Acute GVHD is staged as follows:
* Overall grade (skin-liver-gut) with each organ staged individually from a low of 1 to a high of 4.
* Patients with grade IV GVHD usually have a poor prognosis. 
* If the GVHD is severe and requires intense [[immunosuppression]] involving steroids and additional agents to get under control, the patient may develop severe infections as a result of the [[immunosuppression]] and the risk of mortality secondary to infection increases significantly.


==References==
==References==
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[[Category:Primary care]]
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Revision as of 16:58, 3 July 2017

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.

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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