Multiple Oral Manifestations in a Patient With Chronic Graft Versus Host Disease: A Case Report

Area of Science:

• Hematology
• Immunology
• Oral Medicine

Background:

• Hematopoietic stem cell transplantation (HSCT) is a vital curative therapy for hematologic malignancies.
• Graft-versus-host disease (GVHD) is a major post-transplant complication, with chronic GVHD (cGVHD) presenting unique challenges.
• Oral manifestations of cGVHD require specialized, multidisciplinary care to prevent progression and maintain quality of life.

Observation:

• A 60-year-old female patient developed severe oral symptoms seven years post-HSCT.
• Symptoms included xerostomia (dry mouth), oral pain, a brown-yellow tongue, and extensive dental caries.
• Clinical examination revealed a hairy tongue, reduced salivary function, oral leukoplakia, and salivary and lacrimal gland dysfunction.

Findings:

• The patient's oral symptoms, including hairy tongue and dental caries, were attributed to chronic GVHD.
• Biopsy of oral lesions showed mild epithelial hyperplasia.
• Treatment led to complete resolution of symptoms without recurrence at six months.

Implications:

• This case underscores the long-term oral health risks associated with cGVHD after HSCT.
• Highlights the necessity of prompt diagnosis, targeted interventions, and consistent follow-up for oral cGVHD.
• Emphasizes the importance of a multidisciplinary approach in managing oral complications to ensure favorable patient outcomes.