TY - JOUR
T1 - Cerebral angiitis in four patients with chronic GVHD
AU - Sostak, P.
AU - Padovan, C. S.
AU - Eigenbrod, S.
AU - Roeber, S.
AU - Segerer, S.
AU - Schankin, C.
AU - Siegert, S.
AU - Saam, T.
AU - Theil, D.
AU - Kolb, H. J.
AU - Kretzschmar, H.
AU - Straube, A.
PY - 2010/7
Y1 - 2010/7
N2 - There is growing evidence that GVHD affects the central nervous system (CNS). In this study, we describe the long-term follow-up of four allogeneic BM recipients who developed cerebral angiitis-like disease probably due to GVHD. The patients developed focal neurological signs, cognitive deficits and/or coma in association with GVHD, 2-18 years after transplantation, following reduction of immunosuppressive therapy. Magnetic resonance imaging was variable, showing generalized brain atrophy, ischemic lesions or leukoencephalopathy. Diagnosis of cerebral angiitis was confirmed by histopathological analysis of bioptic brain tissue and response to immunosuppressive therapy. By means of immunohistochemistry and immunofluorescence, perivascular lymphomononuclear cerebral infiltrates were shown to express the adhesion receptor, CD11a, and the chemokine receptor, CCR5. Our findings imply that GVHD should be considered in the differential diagnosis of noninfectious angiitis-like disease of the CNS in long-term survivors after allogeneic BMT. Infiltrating cells, in analogy to typical target organs of GVHD such as skin or liver, expressed CD11a and CCR5. These findings could be of etiopathological, diagnostic and therapeutic relevance.
AB - There is growing evidence that GVHD affects the central nervous system (CNS). In this study, we describe the long-term follow-up of four allogeneic BM recipients who developed cerebral angiitis-like disease probably due to GVHD. The patients developed focal neurological signs, cognitive deficits and/or coma in association with GVHD, 2-18 years after transplantation, following reduction of immunosuppressive therapy. Magnetic resonance imaging was variable, showing generalized brain atrophy, ischemic lesions or leukoencephalopathy. Diagnosis of cerebral angiitis was confirmed by histopathological analysis of bioptic brain tissue and response to immunosuppressive therapy. By means of immunohistochemistry and immunofluorescence, perivascular lymphomononuclear cerebral infiltrates were shown to express the adhesion receptor, CD11a, and the chemokine receptor, CCR5. Our findings imply that GVHD should be considered in the differential diagnosis of noninfectious angiitis-like disease of the CNS in long-term survivors after allogeneic BMT. Infiltrating cells, in analogy to typical target organs of GVHD such as skin or liver, expressed CD11a and CCR5. These findings could be of etiopathological, diagnostic and therapeutic relevance.
UR - http://www.scopus.com/inward/record.url?scp=77955012500&partnerID=8YFLogxK
U2 - 10.1038/bmt.2009.323
DO - 10.1038/bmt.2009.323
M3 - Article
C2 - 19915632
AN - SCOPUS:77955012500
SN - 0268-3369
VL - 45
SP - 1181
EP - 1188
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
IS - 7
ER -