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KMID : 0359019940140040494
Korean Journal of Gastrointestinal Endoscopy
1994 Volume.14 No. 4 p.494 ~ p.499
A Case of Intestinal GVHD after Allogeneic Bone Marrow Transplantation for Treatment of Severe Aplastic Anemia
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정재복/민유홍/이승태/문영명/강진경/박인서
Abstract
Bone marrow transplantation has become an accepted treatment for malignancy(particulary leukemia and lymphoma), aplastic anemia, and certain inborn errors of metabolism. In addition to the problem of severe, prolonged myelosuppression, bone
marrow
transplantation is associated with several unusual complications. Among the complications such as GVHD, graft rejection, interstitial pneumonia and veno-occlusive disease, involvement of the gastrointestinal tract by GVHD is associated with high
graft
failure and mortality Intestinal GVHD is usually manifest clinically as voluminous secretory diarrhea accompanied by abdominal eramping, ileus, nutritional depletion, and at times, hemorrhage.
We experienced a case of severe intestinal GVHD after allogeneic marrow transplantation for treatment of severe aplastic anemia. He received bone marrow from his elder sister, HLA-matched multiparous woman and suffered from large amount of watery
diarrhea with skin rash 34 days after transplantation. In spite of prednisolone therapy the symptom was progressed. After sigmoidoscopic mucosal biopsy, intestinal GVHD was confirmed and we tried methylprednisolone pulse therapy. Skin lesion was
improved but the amount of diarrhea was increased with intermittent abdominal cramping. We tried ALG(anti-lymphocyte globulin) and conservative management but the patient didnot respond the therapy. He succumbed to pneumonia and acute respiratory
insufficiency complicated with GVHD, 70days after transplantation.
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