Fact-sheet: Graft-versus-host disease
Updated on 10/07/2017 at 6:27 AM
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Definition
Functional donor T lymphocytes introduced into an immunocompromised recipient cause lesions of the skin, liver, and digestive tract.
Still affects 15 to 50% of patients following allogeneic bone marrow transplantation.
Generally occurs within 100 days of transplantation
Clinical features
The clinical presentation combines febrile abdominal pain, vomiting, and sometimes hemorrhage
CT
- Wall thickening involving both the small bowel and the colon, sometimes in a discontinuous fashion
- Frequent involvement of the duodenojejunum.
- Diffuse involvement of the entire digestive tract but more pronounced at the terminal ileum and cecum.
- Constant involvement of the small bowel.
Circumferential submucosal edema is associated with a halo or target sign.
Mesenteric infiltration and ascites are observed in 50% of cases.
Periportal edema (36% of cases).
Gallbladder wall edema (23% of cases)
Differential diagnosis
Pseudomembranous colitis.
Neutropenic colitis (typhlitis).
CMV colitis