GVHD and CMV Colitis

GVHD Colitis (Left); CMV Colitis (Right)

GVHD Colitis (Left); CMV Colitis (Right)

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)