Angiitis of the central nervous system after allogeneic bone marrow transplantation?

Claudio S. Padovan, Karl Bise, Joachim Hahn, Petra Sostak, Ernst Holler, Hans Jochem Kolb, Andreas Straube

Research output: Contribution to journalArticlepeer-review

83 Scopus citations

Abstract

Background and Purpose - There is only limited information about late neurological complications after bone marrow transplantation (BMT). The purpose of this study is to describe a cerebral angiitis-like syndrome after allogeneic BMT. Methods - Clinical and diagnostic findings of 5 BMT patients with chronic graft versus host disease and neuropathological data of 1 patient were reported. Results - In the described patients, focal neurological signs and neuropsychological abnormalities occurred years after BMT. MRI revealed periventricular white matter lesions, lacunar or territorial infarctions, leukoencephalopathy, and hemorrhages. Angiitis of the central nervous system was confirmed in 1 patient at autopsy, and an angiitis-like syndrome was suspected in the other patients because of the clinical course and response to treatment. Three patients received cyclophosphamide and steroids (2 improved, 1 died), 1 patient improved after steroids alone, and 1 patient without immunosuppressive therapy deteriorated further. Conclusions - We propose that an angiitis-like syndrome of the central nervous system can be a neurological manifestation of graft versus host disease, which should be considered a possible cause of cerebral ischemic episodes and pathological MRI scans in BMT patients with graft versus host disease.

Original languageEnglish
Pages (from-to)1651-1656
Number of pages6
JournalStroke
Volume30
Issue number8
DOIs
StatePublished - Aug 1999
Externally publishedYes

Keywords

  • Angiitis
  • Bone marrow transplantation
  • Cerebral infarction
  • Cerebrovascular disorders
  • Complications
  • Graft vs host disease
  • White matter

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