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[Prolonged acute pancreatitis after bone marrow transplantation]
B De Singly1, M Simon, J Bennani
1Service de Gastroentérologie, Hôpital Saint-Louis, 1 Avenue Claude-Vellefaux, 75475 Paris cedex 10, France.
Gastroenterologie Clinique Et Biologique
|April 2, 2008
Summary
Graft-versus-host disease (GVHD) can cause acute pancreatitis after allogeneic stem cell transplants. Early diagnosis via duodenal biopsy and corticosteroid treatment led to rapid improvement in a patient with pancreatic GVHD.
Area of Science:
- Hematology
- Gastroenterology
- Oncology
Background:
- Acute pancreatitis is a known complication following allogeneic stem cell transplantation.
- Graft-versus-host disease (GVHD) is an underrecognized cause of post-transplant pancreatitis.
- Diagnosing pancreatic GVHD can be challenging, especially without typical GVHD symptoms.
Observation:
- A 54-year-old female developed prolonged, severe pancreatitis two months after allogeneic bone marrow transplantation for acute myeloid leukemia.
- The patient presented with pancreatitis symptoms but lacked other common manifestations of GVHD.
- Diagnosis of pancreatic GVHD was confirmed via duodenal biopsies after five weeks.
Findings:
- Pancreatic involvement in GVHD was diagnosed despite the absence of diarrhea.
- Treatment with corticosteroids resulted in a rapid and dramatic clinical improvement.
Implications:
- This case highlights the importance of considering pancreatic GVHD in transplant patients with unexplained pancreatitis.
- Duodenal biopsies can be crucial for diagnosing pancreatic GVHD, even in atypical presentations.
- Prompt diagnosis and corticosteroid therapy can effectively manage pancreatic GVHD, improving patient outcomes.
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