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Target Concepts:
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Query: UMLS:C0018133 (
graft-versus-host disease
)
18,032
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
The clinical and pathologic data in 18 patients in whom pneumatosis intestinalis developed after bone marrow transplantation were reviewed to determine the significance of this finding. The colon, predominantly the right side, was involved in 17 of the 18 cases.
Pneumatosis intestinalis
developed earlier in the 14 symptomatic patients than in the four asymptomatic patients. Symptoms included diarrhea (12 patients), abdominal pain (six patients), rectal bleeding (two patients), and abdominal distension (two patients). Factors contributing to the development of pneumatosis intestinalis included pretransplantation chemotherapy and radiotherapy, steroid therapy, infectious colitis,
graft-versus-host disease
, and septic shock. Intestinal disease contributed to the deaths of seven patients with pneumatosis intestinalis, necessitated right hemicolectomy in another patient, and resolved with conservative treatment in 10 patients. In summary, bone marrow transplant recipients with pneumatosis intestinalis may follow either a benign or fatal course, depending on the underlying condition of the patient. Clinical correlation is important in determining the significance of this finding.
...
PMID:Pneumatosis intestinalis after bone marrow transplantation. 328 69
Pneumatosis intestinalis
(PI), with or without pneumoperitoneum (PP), may complicate allogenic bone-marrow transplantation (BMT). The aim of our study was to establish the incidence and outcome of this complication following BMT in children. A departmental database was used to identify children who underwent BMT in the 4-year period up to December 1999. The medical records of children who developed PI with or without PP were obtained for further study. All patients were managed without recourse to surgery. Conservative management included 7 days of intravenous antibiotics and 10 days of intestinal rest supported by parenteral nutrition. In the study period, 138 BMTs were carried out. Six children (4%) with a total of 7 episodes of PI/PP were identified, 1 boy and 5 girls with a median age of 8.5 years (range 0.8-11). Neutropenia was noted in 3 children at the time of presentation. Other risk factors identified included alternative BMT donors (5/6), steroid therapy (6/7), and
graft-versus-host disease
(5/6). Organisms were isolated from stool cultures sent at the time of diagnosis in 3 out of 7 instances. Diarrhoea was the predominant presenting symptom. All patients recovered from the acute episode, but 5 died at a mean of 12 months from the development of PI/PP (range 6-17 months). This mortality of 83% compares with a mortality of 33% (43 of 132) for the remainder of children who underwent BMT during the study period. Thus, while initial recovery can be anticipated, the medium-term mortality in this group of children is high.
...
PMID:Conservative management of pneumatosis intestinalis and pneumoperitoneum following bone-marrow transplantation. 1259 66
Hematopoietic stem cell transplantation (HSCT) causes many complications including the development of
graft-versus-host disease
(
GVHD
).
Pneumatosis intestinalis
(PI), a rare side affect in patients with post-HSCT
GVHD
, is uncommonly seen in non-neonatal patients. In neonates, surgical intervention is common, yet in non-neonatal patients, medical management is advisable. We present four pediatric patients who post-HSCT developed
GVHD
and subsequently PI. Surgery was performed on one patient while the other three were successfully managed conservatively. Although PI is rare in this group of patients, clinicians should be aware of this post-HSCT complication to ensure early diagnosis and proper management.
...
PMID:Pneumatosis intestinalis in pediatric hematopoietic stem cell transplantation patients: an uncommon complication. 2243 15
Pneumatosis intestinalis
, which could complicate a spectrum of clinical conditions ranging from benign to life-threatening, is a rarely encountered complication after lung transplantation (LT). We describe two cases in which PI developed as a complication following LT for pulmonary
graft-versus-host disease
(
GVHD
) after hematopoietic stem cell transplantation (HSCT). In addition to the long-term immunosuppression administered for pulmonary
GVHD
, the intense immunosuppression needed after LT might increase the risk of PI in lung transplant recipients after HSCT. Conservative therapy should be considered for the treatment of PI developing after LT.
...
PMID:Pneumatosis intestinalis after lung transplantation for pulmonary graft-versus-host disease. 2960 Jan 2