Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0018133 (graft-versus-host disease)
 18,032 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 57-year-old man underwent an autologous hematopoietic stem cell transplant for mantle cell lymphoma in August 1999. Anemia and thrombocytopenia appeared in November 2001. He was diagnosed with further hematological examination as having acute myeloid leukemia with multilineage dysplasia following secondary myelodysplastic syndrome. He received the allogeneic hematopoietic stem cell transplant from his HLA DRB1 locus mismatched brother in May 2002. The nonmyeloablative preparative regimen consisted of fludarabine 30mg/m2 for 6 days and busulfan 4mg/kg for 2 days. Eosinophilia, decrease of lacrimal fluid and liver dysfunction appeared on Day 104. We diagnosed this as chronic GVHD and treated the patient with prednisolone 10 mg/day. Thereafter, his chronic GVHD gradually improved. He had fever and myalgia in the extremities and lumbar region with elevated serum CPK and aldolase in January 2003. Histological examination led to a diagnosis of polymyositis simultaneously with chronic GVHD. Prednisolone 50 mg/day as an initial dose was started for the polymyositis following which the prednisolone dose was gradually tapered off. The polymyositis improved promptly after the administration of prednisolone and remains in remission with a current maintenance program of prednisolone 5 mg/day.
 ...
PMID:[Chronic GVHD with polymyositis after non-myeloablative stem cell transplantation]. 1644 Aug 6

Polymyositis is an uncommon manifestation as a complication of chronic graft-versus-host disease (GVHD). We report a case of a 55 years' old woman diagnosed as polymyositis 2 years after bone marrow transplantation against T-cell lymphoma. Muscle weakness and the elevation of CPK value were compatible with pathognomonic findings of polymyositis. However, the muscle weakness was distributed particularly into distal lower extremities and neck. It is different from that of the typical findings in autoimmune polymyositis. Histological findings showed atrophy and anisocytosis of muscles without invasion of mononuclear cells. This might be a case of GVHD-induced polymyositis occurring symptomatically after substantially progressing under the treatment with immunosuppressive agents to control chronic GVHD after bone marrow transplantation. The treatment with prednisone (1 mg/kg) brought the rapid improvement of muscle weakness and CPK value as well as mouth dryness and cholestatic liver dysfunction like in primary biliary cirrhosis. Moreover, dose up of cyclosporine and addition of mizolibine allowed for the use of lower dose of prednisone. This case suggested that the mononuclear cells invasion into muscles in a chronic GVHD patient could not always be a definitive finding of chronic GVHD-associated polymyositis because of prior use of immunosuppressive agents.
 ...
PMID:[A case of chronic graft-versus-host disease presenting with polymyositis]. 1940 11