Overlap syndrome: a case report of extensive chronic graft-versus-host disease and literature review
10.3760/cma.j.cn441217-20230308-00313
- VernacularTitle:广泛型慢性移植物抗宿主病重叠综合征1例暨文献复习
- Author:
Yanxia ZHOU
1
;
Shenghui LUO
;
Weixuan QIN
;
Hongjian YE
;
Ying WANG
;
Wenfang CHEN
;
Zhijian LI
;
Wei CHEN
;
Xin WANG
Author Information
1. 中山大学附属第一医院肾内科，广州 510080
- Keywords:
Graft vs host disease;
Glomerulonephritis, membranous;
Graft vs leukemia effect;
Overlap syndrome;
Polyserositis
- From:
Chinese Journal of Nephrology
2023;39(11):851-857
- CountryChina
- Language:Chinese
-
Abstract:
The paper reported a case of a young male patient, with graft-versus-host disease (GVHD) multi-organ involvement lesions after allo-hematopoietic stem cell transplantation. The patient had diverse clinical manifestations, and overlapping acute and chronic disease processes. Acute GVHD were mainly hyperbilirubinemia, with or without elevated transaminase, bloody watery stools; chronic GVHD were highlighted by extensive skin depigmentation, oral mucosal ulcer, sick nails, etc., and chronic signs, such as membranous nephropathy, polyserositis and pulmonary restrictive ventilatory insufficiency. The diagnosis of chronic GVHD mainly relies on medical history combined with clinical manifestations, and it's needed to exclude infections, drugs and tumors. Besides, the rate of missed diagnosis and misdiagnose is high, and it requires multidisciplinary diagnosis and treatment. Combined with the literature review, it indicates that there is a greater risk of GVHD in the male recipient with female donor, and peripheral blood stem cell transplant patients have a higher incidence than bone marrow transplant patients after hematopoietic stem cell transplantation, but the effect of the graft-versus-leukemia exists. Currently, glucocorticoids therapy with or without calcineurin inhibitors are the first-line treatment for GVHD, but the overall prognosis is poor.
