Introduction After hematopoietic stem cell transplantation (HSCT), many patients present genital graft-vs.-host disease (GVHD) that can culminate with sexual problems, which are poorly dimensioned. Aim We hope to draw attention to the need to perform genital biopsy to diagnose genital GVHD, and thus to call attention to the need to incorporate careful attention to sexual health in the treatment of these patients. Methods Five allogeneic stem cell transplant recipients complaining of coital pain after HSCT were clinically diagnosed for genital GVHD. Genital biopsies were given for histological analysis, and microphotographs of the corresponding marked field in the slide were taken. Specimens were evaluated by the site pathologist and then sent to a reference pathologist, each blinded to the histological findings. A literature search was performed in PubMed/MEDLINE (1966–2009) for cross-sectional and cohort studies or trials related to genital GVHD. Expert opinions peer reviews and case reports were also considered. Main Outcome Measures HSCT, genital GVHD, genital biopsy. Results The biopsy showed evidence of dilated apoptotic cells in the basal layer and detachment of the epithelial lining of the mucosa, hyalinization and thickening of collagen fibers, capillary ectasia, and mononuclear inflammatory infiltrate of the submucosa. Three patients presented vulval lesion such as leucoplasia and ulcer on the large lip. Histological analyses showed evidence of epithelial hyperplasia and influx of inflammatory cells to the epithelial surface, intercellular edema and spongiosis, apoptotic bodies on the basal layer of the epithelium, spongiosis, and nuclear vacuolization. A common treatment based on corticotherapy resulted in complete remission of coetaneous or mucous genital lesions in all five patients. Conclusion Genital biopsy is important to differentially diagnose GVHD and secondary symptoms due to hypoestrogenism. Prevention is the most important step in controlling the evolution GVHD in the vagina to prevent vaginal obstruction and sexual dysfunction.
Graft-versus-host disease is one of the main causes of morbidity and mortality in patients submitted to hematopoietic stem cell transplantation. This study reviewed the prevalence of lower female genital tract graft-versus-host disease following hematopoietic stem cell transplantation. A systematic search of the literature for articles published between 1982 and 2015 was performed. A growing number of young women suffering from malignant and benign hematological diseases are receiving allogeneic hematopoietic stem cell transplantation with very satisfactory results in relation to the disease itself. However, these patients face gynecological problems due to graft-versus-host disease. Correct diagnosis and early management are needed to avoid irreversible complications.
Resumo de Tese (9): 609, 2001 RBGOIntrodução: A endometriose é conceituada como uma doença não neoplásica, onde tecido semelhante ao endométrio é encontrado fora da cavidade uterina, mimetizando sua estrutura histológica e função. Sendo assim, apresenta semelhanças com a mucosa do útero, tanto nos aspectos morfológico e imunológico como no estrutural, no que diz respeito à hormônio-dependência. A lesão mais típica da endometriose é o endometrioma que é uma formação cística, ovariana, repleta de líquido espesso e achocolatado, rodeada por cápsula densa e fibrosa. Nesta cápsula apresenta epitélio com estruturas semelhantes ao endométrio. A endometriose é uma doença hormônio-dependente que atinge mulheres no menacme, sendo que o seu caráter endócrino já foi comprovado por vários autores. A estrogênio-dependência de um tecido, pode ser estudada de maneira direta, pela verificação dos receptores hormonais in situ ou indiretamente, como pela análise dos lisossomos. Os lisossomos são organelas presentes no citoplasma da maioria das cé-lulas animais e representam o maior componente do sistema vacuolar citoplasmático, ao lado do complexo de Golgi e dos retículos endoplasmáticos. É considerado um marcador da atividade estrogênica, visto que Freitas (1987) desvelou haver hormônio-dependência desta organela nas tubas uterinas humanas, sendo o estrogênio estimulador e a progesterona inibidora de sua proliferação. Objetivos: O lisossomo é um verdadeiro marcador da atividade estrogênica e como o endometrioma não responde bem à terapia medicamentosa, propusemo-nos
Next steps are to collate the data from the tacrolimus flowsheet to outline our current state. This process is necessary to establish the ideal state. We hope to establish standard guidelines that can be followed to establish a SCT PharmD driven tacrolimus dosing program. Lastly, we hope to audit this process with hopes of evaluating rates of GVHD rates.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.