A Case of Chronic Graft-versus-host Disease with Symptoms of Masticatory Muscles

Abstract

Lichenoid changes, plate-like keratosis, and restriction of opening due to sclerotic lesion are typical lesions of oral GVHD. However, no case of opening failure due to masticatory muscle tone has been reported.
We report a case of chronic GVHD presenting with masticatory muscle symptoms on admission. The patient, a 67-year-old man, developed dry eye after allogeneic bone marrow transplantation for myelodysplastic syndrome （MDS）/acute myeloid leukemia （AML） skin GVHD. The tooth, which was the source of infection, was extracted at a nearby hospital. After receiving prosthetic treatment, he started to experience muscle tension of the masticatory muscle and accidentally bit under the lip. The results of a head MRI scan did not reveal any central neurodegenerative diseases such as dystonia. A stabilization splint was set and a partial denture inserted, which resulted in improvement. Although masseter hypertrophy and trismus occurred, there was no deterioration even during the course of observation.