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Polyneuropathy complicating bone marrow and solid organ transplantation

A A Amato1, R J Barohn, Z Sahenk

  • 1Department of Neurology, Ohio State University School of Medicine, Columbus.

Neurology
|August 1, 1993
PubMed
Summary

A generalized polyneuropathy can occur after tissue transplantation, particularly with graft-versus-host disease or organ rejection. This neurological complication often improves with immunosuppressive therapy or resolution of the underlying condition.

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Area of Science:

  • Neurology
  • Immunology
  • Transplantation Medicine

Background:

  • Graft-versus-host disease (GVHD) and solid organ rejection are known complications following transplantation.
  • Neurological complications are less commonly reported but can significantly impact patient outcomes.

Purpose of the Study:

  • To investigate the occurrence and characteristics of generalized polyneuropathy in patients undergoing transplantation.
  • To determine the relationship between polyneuropathy and graft-versus-host disease or organ rejection.

Main Methods:

  • Case series reporting on four patients with bone marrow transplants and two with solid organ transplants.
  • Clinical examination, cerebrospinal fluid (CSF) analysis, and electrophysiologic studies were performed.
  • Assessment of neuropathy progression and response to immunosuppressive treatment.

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Main Results:

  • Four patients developed generalized polyneuropathy associated with graft-versus-host disease after bone marrow transplantation.
  • Two patients experienced polyneuropathy alongside solid organ rejection (heart and kidney).
  • Neuropathy presented with proximal and distal muscle involvement, areflexia, and often elevated CSF protein; electrophysiology did not show demyelination.
  • Symptoms improved with immunosuppression or resolution of GVHD/rejection.

Conclusions:

  • Generalized polyneuropathy is a potential complication following tissue transplantation.
  • The development of polyneuropathy warrants consideration in transplant recipients, especially those with GVHD or organ rejection.
  • Immunosuppressive treatment or resolution of the underlying condition can lead to improvement in transplant-associated polyneuropathy.