title: Chronic demyelinating polyneuropathy in graft-versus-host disease following allogeneic bone marrow transplantation.
abstract: In recent years a novel problem has arisen in organ transplantation medicine, namely GVHD. The nervous system has been involved mainly at the level of the CNS and this can lead to a serious outcome for the patient. In rare cases, peripheral nerves may be affected and show acute or chronic polyneuropathy. Here a case is reported of polyneuropathy associated with chronic GVHD. A 32-year-old man, suffering from chronic GVHD following an allogeneic bone marrow transplantation (BMT) for malignant lymphoma at the age of 25, developed a motor dominant polyneuropathy 5 years later. Electrophysiologic studies demonstrated the demyelinating type of polyneuropathy. Biopsy specimens from skin and skeletal muscle disclosed perivascular lymphocytic infiltrates expressing T-cell markers. The sural nerve showed a loss of myelinated nerve fibers with epineurial fibrosis and rare occurrence of T cells, but without obvious vasculitic changes. The present case suggested that polyneuropathy could develop in association with chronic GVHD in some patients with a long-standing disease course.
authors.affiliation: Department of Neurology, Teine Keijinkai Hospital, Japan.
authors.forename: Toshiko
authors.initials: T
authors.lastname: Nagashima
authors.forename: Fumie
authors.initials: F
authors.lastname: Sato
authors.forename: Takayo
authors.initials: T
authors.lastname: Chuma
authors.forename: Yukio
authors.initials: Y
authors.lastname: Mano
authors.forename: Isao
authors.initials: I
authors.lastname: Sasaki
authors.forename: Masamitsu
authors.initials: M
authors.lastname: Mori
authors.forename: Toshio
authors.initials: T
authors.lastname: Higa
authors.forename: Nobuo
authors.initials: N
authors.lastname: Masauji
authors.forename: Masaharu
authors.initials: M
authors.lastname: Kasai
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Orba
authors.forename: Toshiya
authors.initials: T
authors.lastname: Shinohara
authors.forename: Kazuo
authors.initials: K
authors.lastname: Nagashima
mesh_terms: D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002908:Chronic Disease; D003711:Demyelinating Diseases / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D006086:Graft vs Host Disease / Q000150:complications* / Q000276:immunology; D006801:Humans; D008223:Lymphoma / Q000628:therapy; D008297:Male; D011115:Polyneuropathies / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D013601:T-Lymphocytes / Q000276:immunology