PDF(Pubmed)
Abstract：
Graft-versus-host disease (GvHD) is a severe complication following hematopoietic cell transplantation (HCT). The clinical manifestations of GvHD can affect multiple systems. Although gastrointestinal (GI) GvHD is common, GI obstruction complications are rare. Here, we present a case of GI-GvHD after HCT for acute myeloid leukemia (AML) in a young girl from China. The patient suffered from watery diarrhea, which progressed to bloody diarrhea 40 days after HCT. She experienced prolonged and repeated mucous or bloody stool after the withdrawal of cyclosporine and the gradual reduction in methylprednisolone. The plain abdominal radiography and computed tomographic (CT) scan showed apparent bowel wall thickening and intestinal stenosis 10 months after HCT. Finally, the patient underwent surgery to remove the small intestinal stenosis at the age of 26 months. The patient recovered with the help of appropriate medical therapies and nutritional support during hospitalization. She remained stable, and there was no recurrence of GI symptoms 16 months after the surgery. In summary, surgery may be an optimal treatment for GvHD patients with persistent bowel obstruction and failure of appropriate immunosuppressive therapies.
摘要：
移植物抗宿主病（GvHD）是造血细胞移植（HCT）后的严重并发症。GvHD的临床表现可影响多个系统。虽然胃肠道（GI）GvHD很常见，消化道梗阻并发症很少见。这里,我们介绍了一名来自中国的年轻女孩在HCT治疗急性髓细胞性白血病（AML）后发生GI-GvHD的情况。病人患有水样腹泻,HCT后40天进展为血性腹泻。在停用环孢素和逐渐减少甲基强的松龙后，她经历了长时间和反复的粘液或血性粪便。HCT后10个月，腹部平片和计算机断层扫描（CT）扫描显示明显的肠壁增厚和肠狭窄。最后,患者在26个月时接受了切除小肠狭窄的手术。在住院期间，患者在适当的药物治疗和营养支持的帮助下康复。她保持稳定,术后16个月没有复发胃肠道症状。总之,对于持续的肠梗阻和适当的免疫抑制治疗失败的GvHD患者,手术可能是最佳治疗方法.
