Constrictive Pericarditis as a Rare Manifestation of Graft-Versus-Host Disease: A Case Report

Graft-versus-host disease (GVHD) is a serious inflammatory complication that can arise after allogeneic transplantation, characterized by donor T-cells attacking the recipient's tissues. While cardiac complications are infrequent, they are more commonly observed in cases of chronic GVHD and may manifest as pericardial effusion, cardiac tamponade, and various arrhythmias. Additionally, chronic GVHD can result in constrictive pericarditis (CP) due to the accumulation of fluid and scarring. A 25-year-old Iranian man developed CP 14 years after undergoing allogenic stem cell transplantation. Following inadequate response to medical therapy, he underwent a pericardiectomy. Pathological examination during follow-up revealed fibrosis and mild chronic inflammation. This report aims to add another case of cardiac manifestation associated with GVHD to the current literature. The main message emphasizes the urgent need for prompt diagnosis and effective pericardiectomy, which can be life-saving. Surgical referral should always be an option, and post-operative immunomodulation is crucial.