Graft versus host disease

Last updated: Friday, 03, December, 2010
ManifestationsAppropriate Tests

Acute

Caused by donor-derived lymphocytes reacting against recipient tissues, usually following bone marrow transplantation.

These lymphocytes originate from the bone marrow graft, or from unirradiated blood products given post-transplant.

It has also been reported (rarely) after blood transfusion especially with directed (family) donation.

This occurs in immunocompetent subjects and usually follow an acute course.

Occurs up to 100 days following transplantation.

Skin rashes 

Skin biopsy (affected area).

Erythroderma

Hepatitis

Bilirubin, ALP, ALT, AST, GGT; liver biopsy if indicated.

Diarrhoea

Colorectal biopsy may be indicated.

See Diarrhoea-chronic

Abdominal pain

Pancytopenia

FBC; bone marrow aspiration may be indicated.

Chronic

Occurring more than 100 days after transplantation.

Skin rashes 

Skin biopsy (affected area) may be indicated.

Malabsorption

Small bowel biopsy, if indicated.

Hyposplenism 

See Splenic atrophy/absence.

Bronchiolitis obliterans

Scleroderma-like syndrome

Sicca syndrome

Cataracts

Alopecia