Graft-versus-host disease-related polymyositis

Area of Science:

• Hematology
• Immunology
• Neurology

Background:

• Chronic graft-versus-host disease (GVHD) can present with diverse clinical manifestations.
• GVHD may mimic various autoimmune disorders, complicating diagnosis.
• Polymyositis is a rare but serious manifestation of chronic GVHD.

Observation:

• A 39-year-old patient developed atypical polymyositis without elevated creatinine phosphokinase levels.
• The polymyositis was associated with chronic GVHD after interruption of immunosuppressive therapy.
• Symptoms were clinically indistinguishable from idiopathic polymyositis.

Findings:

• Diagnosis of GVHD-related polymyositis is suggested by the transplantation context and reduced immunosuppression, especially with other GVHD signs.
• Treatment with a combination of cyclosporine and corticosteroids led to complete and sustained remission of polymyositis.
• The condition can be effectively managed even in severe cases.

Implications:

• GVHD-related polymyositis requires high clinical suspicion in transplant recipients.
• Early diagnosis and appropriate immunosuppressive therapy are crucial for favorable outcomes.
• This case underscores the importance of monitoring for GVHD manifestations post-transplant.