Illness Script for Acute GVHD Colitis:
- Predisposing Conditions: Seen in patients who are less than 100 days post allogeneic hematopoietic stem cell transplant around the time of white blood cell engraftment. Increased risk with disparity in male/female donors, HLA mismatch.
- Pathophysiological Insult: The donor cells recognize the host as foreign and then initiate an immune reaction creating disease in the recipient.
- Clinical Consequences: Copious watery diarrhea, with later stages possible bloody diarrhea.
- Discussion of treatment of GVHD
Illness Script for CMV colitis:
- Predisposing Conditions: Usually in patients that are immunocompromised (post transplant, HIV)
- Pathophysiological Insult: Infection with the CMV virus
- Clinical Consequences: Copious watery diarrhea, abdominal pain and possibly low grade fevers.
In patients with known GVHD, 12% will also develop CMV colitis, with a median presentation at 52 days post stem cell transplant. (reference)