Relapsing polymyositis in chronic graft versus host disease

Area of Science:

• Immunology
• Oncology
• Neurology

Background:

• Allogeneic hematopoietic stem cell transplantation (HSCT) is a curative therapy for hematologic malignancies.
• Chronic graft-versus-host disease (GVHD) remains a significant cause of long-term morbidity and mortality post-HSCT.
• Skeletal muscle involvement in chronic GVHD is uncommon, with polymyositis being a rare presentation.

Observation:

• A 54-year-old male with acute myeloid lymphoma underwent HSCT.
• The patient developed acute gastrointestinal GVHD and subsequently polymyositis.
• Polymyositis recurred upon reduction of immunosuppressive steroid therapy.

Findings:

• This case illustrates a rare manifestation of chronic GVHD presenting as polymyositis.
• The patient experienced a relapse of polymyositis, indicating a potential challenge in treatment management.
• Steroid tapering was associated with disease recurrence.

Implications:

• Early recognition of polymyositis in chronic GVHD patients is crucial for timely intervention.
• Management strategies for polymyositis in chronic GVHD may require prolonged or adjusted immunosuppression.
• Further research into the pathogenesis and optimal treatment of GVHD-induced polymyositis is warranted.