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Post-Transplant Complications

The incidence, pathogenesis and natural history of steatorrhoea after bone marrow transplantation

Summary:

A small number of case reports of steatorrhoea after allogeneic BMT have been published, but the incidence and natural history of this complication have not been defined. We reviewed the incidence of steatorrhoea in 184 consecutive allograft recipients surviving at least 100 days. Steatorrhoea was documented in five patients, a median of 5.5 months (range 4–14) post-transplant. All patients had recent or concomitant acute gut or liver graft versus host disease (GVHD). The probability of developing steatorrhoea by 2 years post-transplant was 3.3% (95% confidence interval (CI) ±2.9%) in the group overall, rising to 4.8% (CI ±4.2%) in patients with acute and/or extensive chronic GVHD. All patients responded clinically to pancreatic enzyme supplements. While these observations are consistent with previously reported autopsy data suggesting that GVHD of the exocrine pancreas is likely to be the predominant underlying pathological process, in two patients concomitant small bowel or hepatic dysfunction may have contributed to the severity of steatorrhoea. Enzyme supplements were subsequently ceased in three patients without return of steatorrhoea, suggesting that the process is usually reversible. Our data demonstrate that steatorrhoea is not an infrequent complication in the 2 years postallograft, particularly in patients with GVHD.

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References

  1. Jurges E, El Tumi M, O'Donohue J, Hobbs J . Pancreatic insufficiency after bone marrow transplantation (letter). Lancet 1991; 338: 517.

    Article  CAS  Google Scholar 

  2. Anderson H, Grimes DS, Morgenstern AR, Scarffe JH . Pancreatic insufficiency after bone marrow transplantation (letter). Lancet 1991; 338: 1089.

    Google Scholar 

  3. Akpek G, Valladares JL, Lee L, Margolis J, Vogelsang GB . Pancreatic insufficiency in patients with chronic graft-versus-host disease. Bone Marrow Transplant 2001; 27: 163–166.

    Article  CAS  Google Scholar 

  4. Foulis AK, Farquharson MA, Gale GE . The pancreas in acute graft versus host disease in man. Histopathology 1989; 14: 121–128.

    Article  CAS  Google Scholar 

  5. Fromm H, Thomas PJ, Hofmann AF . Sensitivity and specificity in tests of distal ileal function: prospective comparison of bile acid and Vitamin B12 absorption in ileal resection patients. Gastroenterology 1973; 64: 1077–1090.

    CAS  PubMed  Google Scholar 

  6. Linscheer WG . Malabsorption in cirrhosis. Am J Clin Nutr 1970; 23: 488–492.

    Article  CAS  Google Scholar 

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Grigg, A., Angus, P., Hoyt, R. et al. The incidence, pathogenesis and natural history of steatorrhoea after bone marrow transplantation. Bone Marrow Transplant 31, 701–703 (2003). https://doi.org/10.1038/sj.bmt.1703911

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