Oral manifestations in chronic graft-versus-host disease
Thorn, J.J.; Schiødt, M.; Jacobsen, N.
Ugeskrift for Laeger 149(10): 648-651
1987
ISSN/ISBN: 0041-5782 PMID: 3554679 Document Number: 295904
Certain mucosal abnormalities are frequently seen with the presence of chronic graft-versus-host disease (GvHD) after allogenic bone marrow transplantation. Preliminary experience of mucosal affections in Danish patients with chronic GvHD is presented. Chronic GvHD occurred in 16 out of 55 long-term survivors. Fourteen developed mucosal alterations, and they were usually among the first symptoms. Most frequently reticular, erythematous and ulcerative affections were observed which resembled oral lichenoid affections. These alterations in the oral mucosa are though to be characteristic features of chronic GvHD. In seven cases, generalized mucosal hyperkeratinization was observed initially, and two other patients developed multiple vesicles ("saliva retention phenomenon" (4)). The two latter types of mucosal affections, resembling no other oral disease, are thought to be specific manifestations of GvHD. In a few cases, the oral mucosa normalized along with improvement of other symptoms without any treatment of chronic GvHD. This may be indicative of the existence of a mild, transient form of chronic GvHD which involves the oral mucosa in typical patterns. The predictive value of oral manifestations still requires elucidation. The precise pathogenesis of oral and general GvHD remains obscure.