| Autor: |
Osamu Imataki, Shumpei Uchida, Shigeyuki Yokokura, Makiko Uemura, Norimitsu Kadowaki |
| Jazyk: |
angličtina |
| Rok vydání: |
2018 |
| Předmět: |
|
| Zdroj: |
Transplantation Reports, Vol 3, Iss 2, Pp 9-12 (2018) |
| Druh dokumentu: |
article |
| ISSN: |
2451-9596 |
| DOI: |
10.1016/j.tpr.2018.05.002 |
| Popis: |
Background: Although the biology of steroid-refractory acute GVHD is still unknown, the pathogenesis of steroid-refractory acute GVHD is recognized to be associated with aberrant cytokine milieu. Case presentation: We treated a 41-year-old Japanese male representing a characteristic clinical manifestation among unspecific cases of heterogeneous steroid-refractory acute GVHD. The patient underwent allogeneic bone marrow transplantation due to relapsed neurolymphomatosis. He achieved neutrophil engraftment on day 21 with mild engraftment fever. Acute GVHD occurred on day 56 after transplantation with systemic skin eruptions and precedent body weight gain. Corneal ulceration and gut GVHD symptoms followed the skin lesions sequentially. A biopsy of skin and gut mucosa revealed pathological GVHD. We recognized that the patient presented anasarca symptoms due to acute GVHD. We treated the patient with 1.0 mg/kg corticosteroids (prednisolone) starting on day 68, but his edema worsened. He did not respond to 2.0 mg/kg prednisolone from day 80. He required artificial ventilation on day 80 due to the bilateral massive pleural effusion and died of respiratory failure on day 99 after transplantation. A measurement of serum cytokines before corticosteroid therapy, IL-6 (61.5 pg/mL; normal range: |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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