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Chronic demyelinating polyneuropathy in graft‐versus‐host disease following allogeneic bone marrow transplantation
Author(s) -
Nagashima Toshiko,
Sato Fumie,
Chuma Takayo,
Mano Yukio,
Sasaki Isao,
Mori Masamitsu,
Higa Toshio,
Masauji Nobuo,
Kasai Masaharu,
Orba Yasuko,
Shinohara Toshiya,
Nagashima Kazuo
Publication year - 2002
Publication title -
neuropathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.701
H-Index - 61
eISSN - 1440-1789
pISSN - 0919-6544
DOI - 10.1046/j.0919-6544.2002.00419_22_1.x
Subject(s) - medicine , polyneuropathy , sural nerve , pathology , transplantation , fibrosis , graft versus host disease , chronic inflammatory demyelinating polyneuropathy , bone marrow , biopsy , disease , immunology , surgery , antibody
In recent years a novel problem has arisen in organ transplantation medicine, namely GVHD. The nervous system has been involved mainly at the level of the CNS and this can lead to a serious outcome for the patient. In rare cases, peripheral nerves may be affected and show acute or chronic polyneuropathy. Here a case is reported of polyneuropathy associated with chronic GVHD. A 32‐year‐old man, suffering from chronic GVHD following an allogeneic bone marrow transplantation (BMT) for malignant lymphoma at the age of 25, developed a motor dominant polyneuropathy 5 years later. Electrophysiologic studies demonstrated the demyelinating type of polyneuropathy. Biopsy specimens from skin and skeletal muscle disclosed perivascular lymphocytic infiltrates expressing T‐cell markers. The sural nerve showed a loss of myelinated nerve fibers with epineurial fibrosis and rare occurrence of T cells, but without obvious vasculitic changes. The present case suggested that polyneuropathy could develop in association with chronic GVHD in some patients with a longstanding disease course.