Dyskeratosis congenita vs. chronic graft versus host disease: report of a case and a review of the literature.
Dyskeratosis congenita (DC) is a rare inherited bone marrow failure syndrome characterized by the triad of reticular pigmentation of the skin, nail dystrophy, and mucosal leukoplakia. DC is often associated with severe pancytopenia, and bone marrow failure is the principal cause of early mortality. Malignant transformation of mucosal leukoplakias may also occur. Rarely, aplastic anemia precedes the other clinical manifestations of the disease. We present a case of a 13-year-old boy who was diagnosed at age four with idopathic aplastic anemia, was treated successfully with an allogeneic bone marrow transplant, then subsequently developed skin, nail, and tongue lesions. While the initial impression was chronic graft-versus-host disease, additional work-up confirmed the diagnosis of DC.
Treister
Nathaniel
N
Department of Oral Medicine, Infection, and Immunity, Harvard University School of Dental Medicine, Boston, Mass, USA. ntreister@student.med.harvard.edu
Lehmann
Leslie E
LE
Cherrick
Irene
I
Guinan
Eva C
EC
Woo
Sook-Bin
SB
D000293:Adolescent; D000741:Anemia, Aplastic / Q000628:therapy; D016026:Bone Marrow Transplantation; D003937:Diagnosis, Differential; D019871:Dyskeratosis Congenita / Q000175:diagnosis* / Q000473:pathology; D006086:Graft vs Host Disease / Q000175:diagnosis*; D006801:Humans; D007971:Leukoplakia / Q000473:pathology; D007972:Leukoplakia, Oral / Q000473:pathology; D008297:Male; D012878:Skin Neoplasms / Q000473:pathology; D014062:Tongue Neoplasms / Q000473:pathology