Exocrine Pancreatic Insufficiency Possibly Related to Atypical Chronic Graft-versus-Host Disease
We report the case of a 66-year-old woman who presented with diarrhea and weight loss approximately 14 months after unrelated allogeneic bone marrow transplantation for acute myeloid leukemia. Her early post-transplant course was notable for mild acute skin graft-versus-host disease (GVHD) and biops...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Karger Publishers
2023-09-01
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| Series: | Case Reports in Oncology |
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| Online Access: | https://beta.karger.com/Article/FullText/533381 |
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| author | Yuka Hosokawa Tomomi Toubai Koichi Ohya Yusuke Nagano Yuki Ishizawa Masashi Hosokawa Ryo Sato Shotaro Watanabe Akane Yamada Takuma Suzuki Keiko Aizawa Satoshi Ito Yusuke Onozato Daniel Peltier Kenichi Ishizawa |
| author_facet | Yuka Hosokawa Tomomi Toubai Koichi Ohya Yusuke Nagano Yuki Ishizawa Masashi Hosokawa Ryo Sato Shotaro Watanabe Akane Yamada Takuma Suzuki Keiko Aizawa Satoshi Ito Yusuke Onozato Daniel Peltier Kenichi Ishizawa |
| author_sort | Yuka Hosokawa |
| collection | DOAJ |
| description | We report the case of a 66-year-old woman who presented with diarrhea and weight loss approximately 14 months after unrelated allogeneic bone marrow transplantation for acute myeloid leukemia. Her early post-transplant course was notable for mild acute skin graft-versus-host disease (GVHD) and biopsy-proven upper gastrointestinal (GI) acute GVHD, both of which resolved with treatment. She then developed weight loss and diarrhea treated with prednisolone for what was thought to be GI late acute GVHD. However, her diarrhea and weight loss persisted. Colonoscopy showed a grossly intact mucosa, and stool studies only confirmed steatorrhea. However, an atrophic pancreas was found on an abdominal computed tomography (CT) scan. Exocrine pancreatic enzymes, such as lipase and pancreatic amylase, were markedly decreased, yet pancreatic endocrine function remained intact. The patient’s diarrhea and weight loss improved upon treatment with pancrelipase. Therefore, we suggest that her exocrine pancreatic insufficiency was likely partly caused by atypical chronic GVHD. |
| first_indexed | 2024-03-11T19:33:43Z |
| format | Article |
| id | doaj.art-600e7e253b2248ce9e705fb88588d66b |
| institution | Directory Open Access Journal |
| issn | 1662-6575 |
| language | English |
| last_indexed | 2024-03-11T19:33:43Z |
| publishDate | 2023-09-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Case Reports in Oncology |
| spelling | doaj.art-600e7e253b2248ce9e705fb88588d66b2023-10-06T13:15:01ZengKarger PublishersCase Reports in Oncology1662-65752023-09-0116185786210.1159/000533381533381Exocrine Pancreatic Insufficiency Possibly Related to Atypical Chronic Graft-versus-Host DiseaseYuka Hosokawa0Tomomi Toubai1Koichi Ohya2Yusuke Nagano3Yuki Ishizawa4Masashi Hosokawa5Ryo Sato6Shotaro Watanabe7Akane Yamada8Takuma Suzuki9Keiko Aizawa10Satoshi Ito11Yusuke Onozato12Daniel Peltier13Kenichi Ishizawa14Division of Hematology and Cell Therapy, Department of Internal Medicine III, Yamagata University Faculty of Medicine, Yamagata, JapanDivision of Hematology and Cell Therapy, Department of Internal Medicine III, Yamagata University Faculty of Medicine, Yamagata, JapanDivision of Hematology and Cell Therapy, Department of Internal Medicine III, Yamagata University Faculty of Medicine, Yamagata, JapanDivision of Hematology and Cell Therapy, Department of Internal Medicine III, Yamagata University Faculty of Medicine, Yamagata, JapanDivision of Hematology and Cell Therapy, Department of Internal Medicine III, Yamagata University Faculty of Medicine, Yamagata, JapanDivision of Hematology and Cell Therapy, Department of Internal Medicine III, Yamagata University Faculty of Medicine, Yamagata, JapanDivision of Hematology and Cell Therapy, Department of Internal Medicine III, Yamagata University Faculty of Medicine, Yamagata, JapanDivision of Hematology and Cell Therapy, Department of Internal Medicine III, Yamagata University Faculty of Medicine, Yamagata, JapanDivision of Hematology and Cell Therapy, Department of Internal Medicine III, Yamagata University Faculty of Medicine, Yamagata, JapanDivision of Hematology and Cell Therapy, Department of Internal Medicine III, Yamagata University Faculty of Medicine, Yamagata, JapanDivision of Hematology and Cell Therapy, Department of Internal Medicine III, Yamagata University Faculty of Medicine, Yamagata, JapanDivision of Hematology and Cell Therapy, Department of Internal Medicine III, Yamagata University Faculty of Medicine, Yamagata, JapanDepartment of Internal Medicine II, Yamagata University Faculty of Medicine, Yamagata, JapanDivision of Pediatric Hematology and Oncology, Department of Pediatrics, Herman B. Wells Center for Pediatric Research, Simon Cancer Center, Indiana University School of Medicine, Indianapolis, IN, USADivision of Hematology and Cell Therapy, Department of Internal Medicine III, Yamagata University Faculty of Medicine, Yamagata, JapanWe report the case of a 66-year-old woman who presented with diarrhea and weight loss approximately 14 months after unrelated allogeneic bone marrow transplantation for acute myeloid leukemia. Her early post-transplant course was notable for mild acute skin graft-versus-host disease (GVHD) and biopsy-proven upper gastrointestinal (GI) acute GVHD, both of which resolved with treatment. She then developed weight loss and diarrhea treated with prednisolone for what was thought to be GI late acute GVHD. However, her diarrhea and weight loss persisted. Colonoscopy showed a grossly intact mucosa, and stool studies only confirmed steatorrhea. However, an atrophic pancreas was found on an abdominal computed tomography (CT) scan. Exocrine pancreatic enzymes, such as lipase and pancreatic amylase, were markedly decreased, yet pancreatic endocrine function remained intact. The patient’s diarrhea and weight loss improved upon treatment with pancrelipase. Therefore, we suggest that her exocrine pancreatic insufficiency was likely partly caused by atypical chronic GVHD.https://beta.karger.com/Article/FullText/533381chronic graft-versus-host diseaseexocrine pancreatic insufficiencypancreatic atrophy |
| spellingShingle | Yuka Hosokawa Tomomi Toubai Koichi Ohya Yusuke Nagano Yuki Ishizawa Masashi Hosokawa Ryo Sato Shotaro Watanabe Akane Yamada Takuma Suzuki Keiko Aizawa Satoshi Ito Yusuke Onozato Daniel Peltier Kenichi Ishizawa Exocrine Pancreatic Insufficiency Possibly Related to Atypical Chronic Graft-versus-Host Disease Case Reports in Oncology chronic graft-versus-host disease exocrine pancreatic insufficiency pancreatic atrophy |
| title | Exocrine Pancreatic Insufficiency Possibly Related to Atypical Chronic Graft-versus-Host Disease |
| title_full | Exocrine Pancreatic Insufficiency Possibly Related to Atypical Chronic Graft-versus-Host Disease |
| title_fullStr | Exocrine Pancreatic Insufficiency Possibly Related to Atypical Chronic Graft-versus-Host Disease |
| title_full_unstemmed | Exocrine Pancreatic Insufficiency Possibly Related to Atypical Chronic Graft-versus-Host Disease |
| title_short | Exocrine Pancreatic Insufficiency Possibly Related to Atypical Chronic Graft-versus-Host Disease |
| title_sort | exocrine pancreatic insufficiency possibly related to atypical chronic graft versus host disease |
| topic | chronic graft-versus-host disease exocrine pancreatic insufficiency pancreatic atrophy |
| url | https://beta.karger.com/Article/FullText/533381 |
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