Severe oral manifestations of chronic graft-vs.-host disease.
BACKGROUND
Graft-vs.-host-disease, or GVHD, is the main cause of morbidity in patients who have received bone marrow transplants. Chronic GVHD, or cGVHD, occurs 100 days or more after the transplant procedure and may take the form of various oral manifestations.


METHODS
A 23-year-old woman received an allogeneic bone marrow transplant. Although prophylactic therapy was provided, the patient developed cGVHD. Appropriate therapy was initiated, and it received a good clinical response at all sites affected by cGVHD, except in the oral cavity. The patient received complete symptomatic relief through revised systemic therapy, improved oral hygiene, use of topical medications and a monitored diet.


CONCLUSIONS
Effective intervention by dentists is an important part of increasing treatment effectiveness and improving quality of life in patients who received bone marrow transplants.
França
C M
CM
Department of Oral Pathology, School of Dentistry, Ibirapuera University, São Paulo, Brazil. crismf@yahoo.com
Domingues-Martins
M
M
Volpe
A
A
Pallotta Filho
R S
RS
Soares de Araújo
N
N
D000328:Adult; D000741:Anemia, Aplastic / Q000628:therapy; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001623:Betamethasone / Q000627:therapeutic use; D016026:Bone Marrow Transplantation; D002908:Chronic Disease; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006086:Graft vs Host Disease / Q000188:drug therapy* / Q000517:prevention & control; D006801:Humans; D007168:IMP Dehydrogenase / Q000037:antagonists & inhibitors; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008727:Methotrexate / Q000627:therapeutic use; D009059:Mouth Diseases / Q000188:drug therapy*; D009067:Mouthwashes / Q000627:therapeutic use; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D009910:Oral Hygiene; D011241:Prednisone / Q000627:therapeutic use; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous
D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D009067:Mouthwashes; D016572:Cyclosporine; D001623:Betamethasone; D007168:IMP Dehydrogenase; D009173:Mycophenolic Acid; D011241:Prednisone; D008727:Methotrexate