title: Cardiac manifestations of graft-versus-host disease.
abstract: Graft-versus-host disease (GVHD) is a major cause of morbidity and mortality after bone marrow transplantation. Well-documented manifestations of GVHD include dermatologic, gastrointestinal, hepatic, pulmonary, musculoskeletal, and hematologic manifestations and sicca syndrome. To date, the heart has only rarely been reported to be a target of GVHD. We report a series of patients who developed bradycardia, coronary artery disease, or cardiomyolysis in association with acute or chronic GVHD. The severity of these manifestations ranged from asymptomatic to fatal. The bradycardias were responsive to increased immunosuppression. Although they are uncommon, it is important to recognize these cardiac manifestations, because they may reflect GVHD activity and may be reversible by increasing immunosuppression.
authors.affiliation: Department of Pediatrics, Children's Memorial Hospital, Chicago, Illinois, USA.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Rackley
authors.forename: Kirk R
authors.initials: KR
authors.lastname: Schultz
authors.forename: Frederick D
authors.initials: FD
authors.lastname: Goldman
authors.forename: Ka Wah
authors.initials: KW
authors.lastname: Chan
authors.forename: Amy
authors.initials: A
authors.lastname: Serrano
authors.forename: James E
authors.initials: JE
authors.lastname: Hulse
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Gilman
mesh_terms: D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects / Q000379:methods; D001919:Bradycardia / Q000188:drug therapy / Q000209:etiology; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D003324:Coronary Artery Disease / Q000209:etiology; D016757:Death, Sudden, Cardiac / Q000209:etiology; D005260:Female; D006086:Graft vs Host Disease / Q000175:diagnosis* / Q000209:etiology; D006331:Heart Diseases / Q000209:etiology*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007165:Immunosuppression Therapy; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D013256:Steroids / Q000627:therapeutic use
chemical_list: D013256:Steroids