Rehabilitation in Children With Sclerodermoid Chronic Graft-Versus-Host Disease: Case Series

Abstract

Joint contracture in chronic graft-versus-host disease (cGVHD) is refractory to treatment, and tends to deteriorate gradually over time. There is scant clinical research focusing on timing and intensity of rehabilitation on joint contractures in children with sclerodermoid cGVHD after hematopoietic stem cell transplantation. We retrospectively reviewed rehabilitative therapeutic effects in 6 children with sclerodermoid cGVHD, whose clinical records documented their condition, before and after rehabilitation therapies. Three children who started treatment within a mean of 2 months after the onset of joint symptoms, and who underwent home-based exercise twice daily for 30 minutes showed more prominent improvement in range of motion compared with the other 3 children, who started rehabilitation therapy later than 6 months after onset of joint symptoms, without regular home-based exercise.

Graft versus host disease-related eosinophilic fasciitis: cohort description and literature review

“…Musculoskeletal symptoms and signs such as arthralgias, myalgias, joint stiffness, edema, and cramps are nonspecific, very frequent, and difficult to attribute to a single cause, but only joint contractures secondary to sclerosis or fasciitis are considered sufficient diagnostic criteria for cGVHD, and these do not require biopsy [12]. Widespread sclerosis may result in joint contractures and severe limitation of function, and common sites of involvement include the hands/wrists, shoulders, elbows, and ankles [16,17]. Fasciitis caused by inflammation of the fascia, including an eosinophilic component, may manifest as joint stiffness, erythema, edema, arthralgia, restricted range of motion (ROM), and, rarely, as synovitis.…”