Graft-versus-host disease: gastrointestinal involvement with a rectovaginal fistula

• Published in: Journal of pediatric gastroenterology and nutrition Vol. 7; no. 2; pp. 288 - 292
• Main Authors: Kessler, B.H, Cochran, W.J, Wagner, M.L, Hawkins, H.K, Klish, W.J
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott-Raven Publishers 01-03-1988; Lippincott
• Subjects: anemia (disease); Anemia, Aplastic - therapy; Biological and medical sciences; bone marrow; Bone Marrow Transplantation; Child; digestive system; Female; fistula; Gastroenterology. Liver. Pancreas. Abdomen; Gastrointestinal Diseases - etiology; graft versus host reactions; Graft vs Host Disease - complications; Graft vs Host Disease - diagnosis; Humans; Medical sciences; Other diseases. Semiology; Rectovaginal Fistula - etiology; rectum; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; transplantation; vagina; Human; Aplastic anemia; Homograft; Various treatments; Vagina; Graft versus host reaction; Fistula; Hemopathy; Rectovaginal; Female genital diseases; Rectum; Bone marrow; Digestive diseases; Child
• ISSN: 0277-2116; 1536-4801
• DOI: 10.1002/j.1536-4801.1988.tb09520.x

Bone marrow transplantation is an accepted form of treatment for aplastic anemia and end-stage hematological malignancies. Despite a satisfactory outcome in selected patients, more than one-half develop acute graft-versus-host disease (GVHD), characterized typically by involvement of the skin, liver, and gastrointestinal tract. We describe an unusual case in which a 10-year-old girl developed gastrointestinal symptoms as the only manifestation of GVHD. The patient presented with a rectovaginal fistula and had clinical, radiological, and histological features of gastrointestinal GVHD without evidence of liver or skin involvement.