Central nervous system graft-versus-host disease: report of two cases and literature review.
Two patients with a plausible diagnosis of central nervous system graft-versus-host disease (CNS-GVHD) are described. Both presented with neurological manifestations 6 and 18 months following allogeneic transplant with hemiparesis, seizure, encephalopathy and magnetic resonance findings of hyperintense white matter lesions on T-2 weighed images. Brain biopsy in one and autopsy in the other revealed profound perivascular lymphocytic infiltrates composed predominantly of T-lymphocytes that were of donor origin. Although an unequivocal diagnosis of CNS-GVHD is difficult to establish, the transplantation community should be aware of this controversial entity.
Kamble
R T
RT
Center for Cell and Gene Therapy, Baylor College of Medicine and Methodist Hospital, Houston, TX 77030, USA. kamble@sbcglobal.net
Chang
C-C
CC
Sanchez
S
S
Carrum
G
G
D000328:Adult; D002051:Burkitt Lymphoma / Q000150:complications* / Q000628:therapy; D005260:Female; D006086:Graft vs Host Disease / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology / Q000517:prevention & control; D006801:Humans; D016399:Lymphoma, T-Cell / Q000150:complications* / Q000628:therapy; D008875:Middle Aged; D010291:Paresis / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology / Q000517:prevention & control; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000628:therapy; D012640:Seizures / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology / Q000517:prevention & control; D013601:T-Lymphocytes / Q000378:metabolism