Year 2023 / Volume 115 / Number 4
Letter
Exocrine pancreatic insufficiency and graft-versus-host disease

210-211

DOI: 10.17235/reed.2022.9143/2022

Julia López Cardona, Carla Senosiaín Lalastra, Francisco Mesonero Gismero, Irene García de la Filia Molina, Sergio Escribano Cruz, Gonzalo Trigo Gallego, Agustín Albillos,

Abstract
We present the case of a 59-year-old man with acute myeloid leukemia treated with allogeneic hematopoietic stem cell transplantation (allo-HSCT). Two years later, he consulted for diarrhea and steatorrhea of 2-3 months of evolution with significant weight loss. Stool cultures and study of parasites were negative. Thyroid and celiac profile, cytomegalovirus viremia and colonoscopy, were normal. Fecal calprotectin and fecal clearance of alpha-1-Antitrypsin were normal but with almost undetectable fecal elastase (<15 ug/g). Pancreatic magnetic resonance reveals a generalized atrophy of the pancreas without other parenchymal or ductal alterations. The patient had no risk factors for chronic pancreatitis and was diagnosed with exocrine pancreatic insufficiency (EPI) associated with chronic graft-versus-host disease (GVHD). GVHD is caused by an immune-mediated reaction by donor T cells recognizing foreign antigens from the recipient. GVHD occurs in 80% of patients after allo-HSCT. Diarrhea is one of the most frequent manifestations, most often due to intestinal damage, opportunistic infections or chemoradiation effects.
Share Button
New comment
Comments
No comments for this article
References
1. Zeiser R, Blazar BR. Pathophysiology of Chronic Graft-versus-Host Disease and Therapeutic Targets. N Engl J Med. 2017;377(26):2565–79.
2. Grigg AP, Angus PW, Hoyt R, et al. The incidence, pathogenesis and natural history of steatorrhoea after bone marrow transplantation. Bone Marrow Transplant. 2003;31(8):701–3.
3. Papadopoulou A, Lloyd DR, Williams MD, et al. Gastrointestinal and nutritional sequelae of bone marrow transplantation. Arch Dis Child. 1996;75(3):208–13.
4. Maringhini A, Gertz MA, DiMagno EP. Exocrine pancreatic insufficiency after allogeneic bone marrow transplantation. Int J Pancreatol. 1995;17(3):243–7.
5. Brook OR, Mullan CP, Mendiratta-Lala M, et al. Pancreatic atrophy in patients with chronic graft-versus-host disease. Abdom Imaging. 2014;39(2):342–7.
Citation tools
López Cardona J, Senosiaín Lalastra C, Mesonero Gismero F, García de la Filia Molina I, Escribano Cruz S, Trigo Gallego G, et all. Exocrine pancreatic insufficiency and graft-versus-host disease. 9143/2022


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 729 visits.
This article has been downloaded 79 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 20/08/2022

Accepted: 29/08/2022

Online First: 23/09/2022

Published: 03/04/2023

Article Online First time: 34 days

Article editing time: 226 days


Share
This article hasn't been rated yet.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2023 y Creative Commons. The Spanish Journal of Gastroenterology