Graft-versus-host disease physical examination: Difference between revisions
Shyam Patel (talk | contribs) |
Shyam Patel (talk | contribs) |
||
Line 7: | Line 7: | ||
==Physical Examination== | ==Physical Examination== | ||
'''Skin''' | |||
* | *erythema<ref name="pmid24914139">{{cite journal| author=Socié G, Ritz J| title=Current issues in chronic graft-versus-host disease. | journal=Blood | year= 2014 | volume= 124 | issue= 3 | pages= 374-84 | pmid=24914139 | doi=10.1182/blood-2014-01-514752 | pmc=4102710 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24914139 }} </ref> | ||
*maculopapular rash<ref name="pmid24914139">{{cite journal| author=Socié G, Ritz J| title=Current issues in chronic graft-versus-host disease. | journal=Blood | year= 2014 | volume= 124 | issue= 3 | pages= 374-84 | pmid=24914139 | doi=10.1182/blood-2014-01-514752 | pmc=4102710 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24914139 }} </ref> | |||
*hyperpigmentation<ref name="pmid24914139">{{cite journal| author=Socié G, Ritz J| title=Current issues in chronic graft-versus-host disease. | journal=Blood | year= 2014 | volume= 124 | issue= 3 | pages= 374-84 | pmid=24914139 | doi=10.1182/blood-2014-01-514752 | pmc=4102710 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24914139 }} </ref> | |||
*lichen planus-like lesions<ref name="pmid24914139">{{cite journal| author=Socié G, Ritz J| title=Current issues in chronic graft-versus-host disease. | journal=Blood | year= 2014 | volume= 124 | issue= 3 | pages= 374-84 | pmid=24914139 | doi=10.1182/blood-2014-01-514752 | pmc=4102710 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24914139 }} </ref> | |||
'''Liver''' | |||
*'''Lungs''' | *jaundice<ref name="pmid24914139">{{cite journal| author=Socié G, Ritz J| title=Current issues in chronic graft-versus-host disease. | journal=Blood | year= 2014 | volume= 124 | issue= 3 | pages= 374-84 | pmid=24914139 | doi=10.1182/blood-2014-01-514752 | pmc=4102710 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24914139 }} </ref> | ||
*pruritis<ref name="pmid24914139">{{cite journal| author=Socié G, Ritz J| title=Current issues in chronic graft-versus-host disease. | journal=Blood | year= 2014 | volume= 124 | issue= 3 | pages= 374-84 | pmid=24914139 | doi=10.1182/blood-2014-01-514752 | pmc=4102710 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24914139 }} </ref> | |||
*scleral icterus<ref name="pmid24914139">{{cite journal| author=Socié G, Ritz J| title=Current issues in chronic graft-versus-host disease. | journal=Blood | year= 2014 | volume= 124 | issue= 3 | pages= 374-84 | pmid=24914139 | doi=10.1182/blood-2014-01-514752 | pmc=4102710 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24914139 }} </ref> | |||
*leg swelling<ref name="pmid24914139">{{cite journal| author=Socié G, Ritz J| title=Current issues in chronic graft-versus-host disease. | journal=Blood | year= 2014 | volume= 124 | issue= 3 | pages= 374-84 | pmid=24914139 | doi=10.1182/blood-2014-01-514752 | pmc=4102710 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24914139 }} </ref> | |||
*tenderness in the right upper quadrant of the abdomen<ref name="pmid24914139">{{cite journal| author=Socié G, Ritz J| title=Current issues in chronic graft-versus-host disease. | journal=Blood | year= 2014 | volume= 124 | issue= 3 | pages= 374-84 | pmid=24914139 | doi=10.1182/blood-2014-01-514752 | pmc=4102710 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24914139 }} </ref> | |||
*bleeding from coagulopathy<ref name="pmid24914139">{{cite journal| author=Socié G, Ritz J| title=Current issues in chronic graft-versus-host disease. | journal=Blood | year= 2014 | volume= 124 | issue= 3 | pages= 374-84 | pmid=24914139 | doi=10.1182/blood-2014-01-514752 | pmc=4102710 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24914139 }} </ref> | |||
*signs of cholestatic hepatitis<ref name="pmid24914139">{{cite journal| author=Socié G, Ritz J| title=Current issues in chronic graft-versus-host disease. | journal=Blood | year= 2014 | volume= 124 | issue= 3 | pages= 374-84 | pmid=24914139 | doi=10.1182/blood-2014-01-514752 | pmc=4102710 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24914139 }} </ref> | |||
'''GI tract''' | |||
*abdominal tenderness | |||
*diarrhea | |||
*hyperactive or hypoactive bowel sounds | |||
'''Lungs''' | |||
Exam findings include decreased breath sounds and crackles (if fluid fills the alveolar space). | |||
Other physical exam findings are based on the particular organ involved. For example, if there is evidence of ocular GvHD, a full ophthalmologic exam should be done. | Other physical exam findings are based on the particular organ involved. For example, if there is evidence of ocular GvHD, a full ophthalmologic exam should be done. |
Revision as of 19:01, 21 June 2017
Graft-versus-host disease |
Differentiating Graft-versus-host disease from other Diseases |
---|
Diagnosis |
Treatment |
Case Studies |
Graft-versus-host disease physical examination On the Web |
American Roentgen Ray Society Images of Graft-versus-host disease physical examination |
Risk calculators and risk factors for Graft-versus-host disease physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Shyam Patel [2]
Overview
The physical exam for GvHD focuses on the organ involved, including the skin, liver, and GI tract. The lungs can also be involved in more rare cases.
Physical Examination
Skin
Liver
- jaundice[1]
- pruritis[1]
- scleral icterus[1]
- leg swelling[1]
- tenderness in the right upper quadrant of the abdomen[1]
- bleeding from coagulopathy[1]
- signs of cholestatic hepatitis[1]
GI tract
- abdominal tenderness
- diarrhea
- hyperactive or hypoactive bowel sounds
Lungs
Exam findings include decreased breath sounds and crackles (if fluid fills the alveolar space).
Other physical exam findings are based on the particular organ involved. For example, if there is evidence of ocular GvHD, a full ophthalmologic exam should be done.