title: A Rare Consequence of Chronic Graft Versus Host Disease - Peyronie's Disease.
abstract: Chronic graft versus host disease (GvHD) after allogeneic stem cell transplantation (SCT) may involve any organ system, but male genital involvement is rare. Peyronie's Disease (PD) is an acquired, localized fibrotic disorder of the tunica albuginea, which leads to penile deformity, pain, and eventually to erectile dysfunction. We report the case of a 52 year old African American male with Acute Myeloid Leukemia who underwent human leucocyte antigen (HLA) matched sibling allogeneic peripheral blood SCT. His post transplant course was complicated by development of acute and multi-organ chronic GvHD requiring prolonged immunosuppression. He developed progressive dorsal curvature of the penis with erections within 1 year of ultra low dose interleukin -2 (IL2) treatment for his chronic GvHD but concealed symptoms for several months. Color Doppler Duplex ultrasound evaluation of the erect penis revealed a 75-degree curvature and appropriate hemodynamic response to prostaglandin injection. He underwent successful incision and grafting of the penile plaque. There is no significant residual curvature and is now able to engage in intercourse. A strong temporal association between GVHD (or its treatment) and Peyronie's is documented here. Awareness of the possible link between PD and chronic GVHD is required in this era of rapid growth in numbers of SCT.
authors.affiliation: Hematology Branch, NHLBI, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Natasha A
authors.initials: NA
authors.lastname: Jain
authors.affiliation: Department of Urology, Medstar Washington Hospital Center, Washington DC, USA.
authors.forename: Krishnan
authors.initials: K
authors.lastname: Venkatesan
authors.affiliation: Hematology Branch, NHLBI, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Prathima
authors.initials: P
authors.lastname: Anandi
authors.affiliation: Hematology Branch, NHLBI, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Sawa
authors.initials: S
authors.lastname: Ito
authors.affiliation: Department of Pathology, Medstar Washington Hospital Center, Washington DC, USA.
authors.forename: Dhruv
authors.initials: D
authors.lastname: Kumar
authors.affiliation: Hematology Branch, NHLBI, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Kit
authors.initials: K
authors.lastname: Lu
authors.affiliation: Hematology Branch, NHLBI, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Minoo
authors.initials: M
authors.lastname: Battiwalla
authors.affiliation: Hematology Branch, NHLBI, National Institutes of Health, Bethesda, MD, USA.
authors.forename: A John
authors.initials: AJ
authors.lastname: Barrett
keywords: Chronic graft versus host disease; Peyronie’s disease