Defecation of a "colon cast" as a rare presentation of acute graft-versus-host disease
Annals of Saudi Medicine. 2009; 29 (3): 231-233
in English
| IMEMR
| ID: emr-90876
ABSTRACT
Diffuse involvement of the gastrointestinal tract by graft versus host disease [GVHD] is a common complication of allogeneic hematopoietic stem cell transplant [HSCT]. Gastrointestinal GVHD usually presents 3 or more weeks after HSCT and is characterized by profuse diarrhea, anorexia, nausea, vomiting, abdominal pain and gastrointestinal bleeding. We report a case of a 23-year-old male who had undergone allogeneic HSCT and presented with bloody diarrhea on the 90th day post-HSCT. On the fourth day of admission, the patient passed per rectum a 27-cm long pinkish colored fleshy material recognized as a "colon cast". Sigmoidoscopy showed a congested and erythematous rectum with the remaining portion of the "colon cast" attached to the proximal part of the sigmoid colon. A biopsy from the rectal wall was suggestive of grade IV GVHD. The patient was treated with methylprednisolone, cyclosporin and mycophenolate mofetil, with a partial response [diarrhea and abdominal pain improved], but then he developed multiple other medical complications and died after 3 months
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Index:
IMEMR (Eastern Mediterranean)
Main subject:
Vomiting
/
Methylprednisolone
/
Abdominal Pain
/
Mortality
/
Sigmoidoscopy
/
Cyclosporine
/
Hematopoietic Stem Cell Transplantation
/
Diarrhea
/
Graft vs Host Disease
/
Gastrointestinal Hemorrhage
Type of study:
Case report
Limits:
Humans
/
Male
Language:
English
Journal:
Ann. Saudi Med.
Year:
2009
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