Blecha, Christiane and Angstwurm, Klemens and Wolff, Daniel and Holler, Ernst and Helbig, Horst and Grassinger, Jochen and Rennert, Janine and Kleiter, Ingo and Huber, Elisabeth and Schmid, Christoph and Dietrich-Ntoukas, Tina (2015) Retinal Involvement in a Patient with Cerebral Manifestation of Chronic Graft-Versus-Host-Disease. ONCOLOGY RESEARCH AND TREATMENT, 38 (10). pp. 532-534. ISSN 2296-5270, 2296-5262
Full text not available from this repository. (Request a copy)Abstract
Background: We report a 35-year-old female patient with cerebral manifestations of chronic graft-versus-host disease (cGvHD) and putative retinal involvement after allogeneic peripheral blood stem cell transplantation (alloHSCT). Patient and Methods: The patient experienced recurrent episodes of fever and encephalitic signs 7 months after alloHSCT during taper of immunosuppression (IS). Results: Cerebral magnetic resonance imaging (MRI) showed non-gadolinium-enhancing confluent periventricular lesions and cerebrospinal fluid inflammation. After exclusion of infectious causes, treatment with steroids and antiepileptics improved cognitive deficits. Steroid reduction provoked a relapse responding to IS. 2 years later, she complained of right-sided blurred vision and floaters; both eyes showed whitish circumscribed retinal infiltrations, cellular infiltration of the vitreous and mild bilateral optic disc edema. Oncological and neurological work-up ruled out infectious diseases and other GvHD manifestations. Symptoms and signs resolved under continued systemic IS, leaving pigmented retinal scars. After IS withdrawal, classical cutaneous cGvHD developed, resolving on systemic IS. 94 months after transplantation, she is doing well. Conclusion: To our knowledge, this is the first observation of retinal involvement of cerebral cGvHD manifestations with retinal infiltrations documented in the absence of other causes and in parallel to periventricular lesions in cerebral MRI. Based on bone marrow histology, we discuss a small vessel pathophysiology of cGvHD. (C) 2015 S. Karger GmbH, Freiburg
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | STEM-CELL TRANSPLANTATION; CONSENSUS CONFERENCE; CLINICAL-PRACTICE; CHRONIC GVHD; Chronic graft-versus-host-disease; Hematology |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Augenheilkunde Medicine > Lehrstuhl für Innere Medizin III (Hämatologie und Internistische Onkologie) Medicine > Lehrstuhl für Neurologie Medicine > Lehrstuhl für Pathologie Medicine > Lehrstuhl für Röntgendiagnostik |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 06 Jun 2019 10:38 |
| Last Modified: | 06 Jun 2019 10:38 |
| URI: | https://pred.uni-regensburg.de/id/eprint/4722 |
Actions (login required)
 |
View Item |
