Abstract
As an adverse immune phenomenon, graft-versus-host disease often occurs after allogeneic hematopoietic stem cell transplantation. The incidence of acute and chronic graft-versus-host disease is about 40–60% and the mortality rate can reach 15%, which is a potentially fatal disease. There are rare GvHD cases involving the central nervous system. We reported a rare case of diffuse white matter changes after haploid bone marrow transplantation, summarizing its clinical manifestations and diagnosis and treatment in conjunction with the literature.
Highlights
A 22-year-old woman suffered headaches, vomiting, progressive unconsciousness, left hemiplegia and dysarthria
The patient’s clinical characteristics met the diagnostic criteria for chronic CNS-graft-versus-host disease (GvHD), but the up to 3 years delayed diffuse white matter lesions shown in magnetic resonance imaging (MRI) were not common in previous cases
The patient exhibited chronic GvHD of the skin that coincided with symptoms of the central nervous system, suggesting the CNS manifestations might be explained by the same reason
Summary
A 22-year-old woman suffered headaches, vomiting, progressive unconsciousness, left hemiplegia and dysarthria. She was diagnosed as leukemia and received an allogeneic hematopoietic cell transplantation (HCT). A 22-year-old woman was accepted to our department for the main complaint of paroxysmal occipital headache and vomiting, following progressive unconsciousness, left hemiplegia and dysarthria for 5 days. For medical history, she was diagnosed as acute myeloid leukemia (AML) M5 3 years ago and received induction remission treatment 1 week after the diagnosis. Neurological examination showed drowsiness, dysphoria, dysphasia, gaze to the right, left hemiplegia, positive left Babinski sign, and positive Kernig sign
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