GVDH, chronic skin reaction with pigment changes. Vasconcelos L, 2013. CC BY NC 3.0

Graft versus host disease (GVHD), (ICD-10: T 86.0)

Definition

Transplanted organs (bone marrow, kidneys, heart and others) from another person can activate the immune system to cause symptoms and illness. A similar reaction can occur after contact with other foreign substances. GVHD gives similar symptoms rheumatic connective tissue disorders, but is often investigated and treated by immunologists.

• GVHD is defined acute rejection reaction when it occurs within NUMX days, later as chronic GVHD Graft-vs-Host Disease

Symptoms

Symptoms from stomach and intestines, skin and fever are most common (24%). Only skin symptoms in 15%. Liver and skin manifestations at 7%. Only liver symptoms of 4%

• Skin symptoms
  • Rashes on neck, ears, shoulders palms and soles
  • "Tanned" skin
  • Blisters and rashes all over the body are more severe symptoms
• Dry mouth and dry eyes (Sjögren's syndrome-like)
• Gastrointestinal (gastrointestinal)
  • Diarrhea
  • Abdominal pain
  • Nausea
• Lever
  • Liver enzymes in the blood are rising
  • ALP and conjugated bilirubin rise first

Incorrect diagnosis? (Similar diseases / differential diagnoses)

• Side Effects of Drugs
  • DRESS syndrome
•  Skin
  • Eczema triggered by medication
  • Virus infections
• Gastrointestinal
  • Infections (Clostridium difficile, CMVreactivation)
  • Liver: Viral hepatitis (Hepatitis B, Hepatitis C)
• Myositis / Dermatomyositis
• Sjögren's syndrome
• Systemic lupus erythematosus (SLE)

Treatment

• Corticosteroids (reference: Goker H, 2001)
• Experimental other treatment (reference: Murata M 2015)

Literature

• Blazar BR, 2012
• Villa NY, 2016 (treatment)

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