2001 Volume 59 Issue 2 Pages 108-109
The patient was a 38-year-old male suffering from acute myelocytic leukemia. He had been treated in the department of hematology at this hospital since November 1998. On May 30, 2000, he was admitted to this hospital for surgical treatment. He underwent a bone marrow transplant on June 22. From July 19, he became febrile and erythema was present all over the body. A skin biopsy specimen was collected from the inside of the upper arm and a diagnosis of acute graft versus host (GVHD) was made on the basis of the results obtained. He had frequent diarrher from July 28, and was transferred to this department for further examination on August 7. He underwent colonoscopy on August 8, and the large intestine was endoscopically observe up to the sigmoid colon. Edematous mucosa was observed and irregular rubefactions and erosions were occasionally detected among severe edemas. There findings and his clinical symptoms were suggestive of GVHD of the intestinal tract or of TMA. In the treatment of patient suffering from repeated episodes of diarrhea after bone marrow transplantation, the possibility of GVHD of the intestinal tract or TMA must be born in mind and implementation of colonoscopy should generally be considered.
