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Visual diagnosis: Chronic diarrhea and failure to thrive in a 5-year-old girl

Mohammed Hasosah1, Mohamed Satti2, Amirshazad Hayat1

  • 1Department of Pediatric Gastroenterology, King Saud Bin Abdulaziz University for Health Sciences, National Guard Health Affairs, Jeddah, Kingdom of Saudi Arabia.

Pediatrics in Review
|June 4, 2014
PubMed

Insights

Chronic graft-versus-host disease (GVHD) can cause diarrhea over 100 days post-BMT. Early evaluation and biopsy are crucial for diagnosing this life-threatening complication of stem cell transplantation.

Area of Science:

  • Medicine
  • Immunology
  • Hematology

Background:

  • Allogeneic stem cell transplantation carries risks, including chronic graft-versus-host disease (GVHD).
  • Chronic GVHD is a significant cause of morbidity and mortality following BMT.
  • It typically manifests over 100 days post-transplant and can present insidiously.

Observation:

  • This case highlights chronic GVHD presenting as chronic diarrhea more than 100 days after BMT.
  • The patient had no prior history of acute GVHD, illustrating de novo disease presentation.
  • Diarrhea can be a key symptom of chronic GVHD.

Findings:

  • Chronic GVHD can manifest with gastrointestinal symptoms like diarrhea.
  • Diagnosis may not be clinically obvious.
  • Gastrointestinal biopsy and histological confirmation are often required.

Implications:

  • Clinicians must consider chronic GVHD in patients with persistent diarrhea post-BMT.
  • Prompt and thorough evaluation, including biopsy, is essential for timely diagnosis and management.
  • Recognizing de novo chronic GVHD is critical for improving outcomes in stem cell transplant recipients.

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