title: Bilateral Sequential Dacryocystitis in a Patient With Graft-Versus-Host Disease.
abstract: A 29-year-old woman with a history of 2 bone marrow transplants for acute myelogenous leukemia developed bilateral sequential dacryocystitis in the context of known ocular graft-versus-host disease. With each infection, the patient underwent uneventful dacryocystorhinostomy. Postoperatively, she developed severe dry eye disease requiring replacement of punctal plugs and use of a prosthetic replacement of the ocular surface ecosystem lens. Histopathologic and immunohistochemical examination of the lacrimal sac showed a dense diffuse nonfollicular lymphocytic subepithelial infiltrate in the lacrimal sac that contained moderately more T-cells than B-cells. This is the first report of acute dacryocystitis associated with graft-versus-host disease. The authors caution that similar patients may develop worsening of ocular surface dryness due to restoration of normal lacrimal outflow.
authors.affiliation: *Ophthalmic Plastic Surgery, Massachusetts Eye and Ear Infirmary, Boston, MA; †Department of Ophthalmology, Harvard Medical School, Boston, MA; ‡David G. Cogan Ophthalmic Pathology Laboratory and §Corneal and External Disease, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A.
authors.forename: Ashley A
authors.initials: AA
authors.lastname: Campbell
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Jakobiec
authors.forename: Alia
authors.initials: A
authors.lastname: Rashid
authors.forename: Reza
authors.initials: R
authors.lastname: Dana
authors.forename: Michael K
authors.initials: MK
authors.lastname: Yoon
mesh_terms: D003607:Dacryocystitis / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D003608:Dacryocystorhinostomy; D003937:Diagnosis, Differential; D006086:Graft vs Host Disease / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009301:Nasolacrimal Duct / Q000000981:diagnostic imaging*