Manifestations of Chronic GVHD in Other Organ Systems
Following HSCT, donor T cells reacting to differences in a recipient’s genetically determined histocompatibility antigens cause acute GVHD (aGVHD). The immunologic targets includes the thymus resulting in the generation of autoreactive T cells, which later lead to autoimmune-like manifestations in chronic GVHD (cGVHD). Well-established manifestations of cGVHD include dermal sclerosis, sicca syndrome, and bronchiolitisobliterans syndrome, as well as eosinophilia and thrombocytopenia. This chapter describes several of the infrequent or rare clinical-pathological autoimmune-like findings associated with cGVHD such as polymyositis, myasthenia gravis, and serositis. Much less common, poorly understood, or controversial are coronary arteritis, retroperitoneal fibrosis associated with elevated IgG4, and lymphocytic cerebritis.
KeywordsChronic GVHD Autoimmunity Thymic injury Polymyositis Myasthenia gravis Serositis Coronary arteritis Retroperitoneal fibrosis Central nervous system manifestation of GVHD Lymphocytic cerebritis Bone marrow involvement with GVHD
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