CellR4 2016; 4 (2): e1814

Delay of the diagnosis of Graft versus host disease in an autologous stem cell transplant recipient: a case report and literature review

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Abstract

Background: Autologous stem cell transplantation is an alternative to allogeneic stem cell transplantation to minimize the complications of genetic discrepancies in mismatching donor cells to the recipient. One such complication, graft-versus-host-disease (GVHD), should theoretically not occur with autologous transplantation given the identical similarity in cells. The literature supporting GVHD in these patients is reviewed and a case presentation of insidious GVHD is demonstrated to emphasize awareness of this elusive disease. A timely and accurate diagnosis can minimize unnecessary hospitalizations, repetitive infectious disease evaluations and maximize utmost patient care in autologous stem cell transplantation patients.

Objective: This case highlights the incidence of graft-versus-host disease occurring in this unique patient population and serves to help elucidate the mechanisms behind this autogenic phenomenon.

Case Description: The patient is a sixty-six-year-old man with a history of multiple myeloma and recent autologous stem cell transplantation who developed a non-specific cutaneous eruption in the setting of refractory diarrhea. The patient was admitted for further work-up and hypothesized to have autologous GVHD readily responsive to steroid therapy.

Conclusions: This case report and literature review highlights the necessary cognizance and recognition of the phenomenon of autologous GVHD. The presentation occurs early after ASCT with non-specific gastrointestinal and cutaneous findings. Misdiagnosis can result in a lack of appropriate treatment and unnecessary hospitalizations. GVHD presenting in autologous stem cell transplantation patients is an elusive diagnosis which should be swiftly recognized and treated.

To cite this article

Delay of the diagnosis of Graft versus host disease in an autologous stem cell transplant recipient: a case report and literature review

CellR4 2016; 4 (2): e1814

Publication History

Published online: 06 Apr 2016