Ruxolitinib Treatment in an Adolescent With Chronic Graft-Versus-Host Disease Mimicking Eosinophilic Gastrointestinal Disorders: A Case Report.

Abstract

BACKGROUND:

Eosinophilic gastrointestinal disorders (EGIDs) are well-documented entities in pediatric solid organ transplantation. However, the diseases are rare after bone marrow transplantation (BMT).

CASE PRESENTATION:

We present an adolescent male with hemoglobin E-β-thalassemia who underwent BMT and developed chronic graft-versus-host disease (GVHD) mimicking EGIDs. Initially, the patient presented with a presumed diagnosis of eosinophilic gastroenteritis (subserosal type) and received corticosteroids for 12 weeks. Six months after corticosteroids cessation, he again developed abdominal pain, treated with corticosteroids, azathioprine, and a six-food elimination diet. Still, he later had similar symptoms with persistent hypereosinophilia. The patient was subsequently diagnosed with chronic GVHD after excluding various potential causes. Ruxolitinib also led to significant clinical improvement and the disappearance of eosinophilia.

CONCLUSION:

The differential diagnosis of chronic GVHD should be a concern in BMT recipients with persistent gastrointestinal symptoms and eosinophilia. Ruxolitinib may be a treatment option in children with a steroid-refractory disease.

• Authors: Songpon Getsuwan, Pornthep Tanpowpong, Suradej Hongeng, Usanarat Anurathapan, Samart Pakakasama, Suporn Treepongkaruna
• Journal: Transplantation proceedings (Transplant Proc) 2022 Jul-Aug Vol. 54 Issue 6 Pg. 1675-1678 ISSN: 1873-2623 [Electronic] United States
• PMID: 35810019 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2022 Elsevier Inc. All rights reserved.

Chemical References

• Adrenal Cortex Hormones
• Nitriles
• Pyrazoles
• Pyrimidines
• Steroids
• ruxolitinib
• Hemoglobin E
• Azathioprine

Topics

• Adolescent
• Adrenal Cortex Hormones (therapeutic use)
• Azathioprine (therapeutic use)
• Child
• Enteritis
• Eosinophilia (diagnosis, drug therapy, etiology)
• Gastritis
• Graft vs Host Disease (diagnosis, drug therapy, etiology)
• Hemoglobin E (therapeutic use)
• Humans
• Male
• Nitriles
• Pyrazoles
• Pyrimidines
• Steroids (therapeutic use)