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Acute intestinal graft-versus-host disease in a syngeneic bone marrow transplant recipient
1Toronto-Sunnybrook Regional Cancer Center, Department of Medicine, University of Toronto, Ontario, Canada. spanerd@srcl.sunnybrook.utoronto.ca
Background:
We report a case of intestinal graft-versus-host disease (GVHD) in a syngeneic bone marrow transplant patient.
Methods:
Several days after receiving a bone marrow transplant from his identical twin for treatment of non-Hodgkin's lymphoma, a 47-year-old man developed a skin rash and diarrhea.
Results:
A colonic biopsy on day +15 revealed characteristic changes of acute intestinal GVHD. Molecular studies (microsatellite DNA and HLA sequence-specific primer polymerase chain reaction analyses) confirmed the genotypic identity of donor and host and the improbability of transfusion-associated GVHD.
Conclusion:
This case illustrates that pathological evidence of GVHD does not absolutely require the presence of genetic differences between host and donor and questions existing concepts about the nature of cyclosporine-induced GVHD.