CASE REPORT: Central nervous system graft-versus-host disease (CNS-GvHD) after allogeneic haematopoietic stem cell transplantation

Blasiak, Karolina Polchlopek
Simonetta, Federico
Vargas, Maria-Isabel
Chalandon, Yves

¹Division of Hematology, Department of Oncology, Hopitaux Universitaires de Genève, Geneva, Switzerland,
²Neuroradiology, Geneva University Hospitals, Geneva, Switzerland,

Correspondence to Dr Karolina Polchlopek Blasiak, e-mail; [email protected] and Professor Yves Chalandon, e-mail; [email protected]

/Accepted December 4, 2017

Contributors Conception and design, planning, conducting, drafting lead, reporting, analysis and interpretation of data and discussion: KPB. Discussion, editing, conception and design, contribution and review: FS. Discussion, radiological part and assessments: M-IV. Planning, supervision, general direction, text review and feedback: YC.

Competing interests None declared.

Patient consent Obtained.

Provenance and peer review Not commissioned; externally peer reviewed.

BMJ Case Reports :p 221840, January 2018. | DOI: 10.1136/bcr-2017-221840

A 60-year-old man presented with impaired consciousness and psychomotor agitation after a second allogeneic haematopoietic stem cell transplantation (HSCT) from a matched unrelated donor for acute myeloid leukaemia. Clinical, biological and radiological evidence suggested a diagnosis of central nervous system graft-versus-host disease (CNS-GvHD). After intrathecal infusion of methylprednisolone, the clinical symptoms as well as the radiological abnormalities disappeared. The present report illustrates the difficulties in the diagnosis and the management of CNS-GvHD, a very rare and still challenging neurological complication that can occur after allogeneic HSCT.