Nail dystrophy, edema, and eosinophilia: harbingers of severe chronic GVHD of the skin in children
The prognostic value of adnexal findings in chronic GVHD (cGVHD) has not been investigated in children. Dermatologic examinations were performed in a severe cohort of 11 children with skin cGVHD seen over a 2-year period. Findings were compared with 25 additional patients with skin cGVHD and 97 cont...
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| Veröffentlicht in: | Bone marrow transplantation (Basingstoke) 2014-12, Vol.49 (12), p.1521-1527 |
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| creator | Huang, J T Duncan, C N Boyer, D Khosravi, H Lehmann, L E Saavedra, A |
| description | The prognostic value of adnexal findings in chronic GVHD (cGVHD) has not been investigated in children. Dermatologic examinations were performed in a severe cohort of 11 children with skin cGVHD seen over a 2-year period. Findings were compared with 25 additional patients with skin cGVHD and 97 control patients. In 36 patients with skin cGVHD, nail dystrophy was present in 45% of patients, and was significantly associated with sclerotic disease and lung cGVHD. Pterygium inversum unguis (PIU) was associated with severe lung disease, with significantly lower % predicted FVC and FEV1 in those with PIU than those without. Forty-four percent of GVHD patients had preceding peripheral edema and 56% had preceding peripheral eosinophilia. Peripheral edema and eosinophilia were significantly associated with sclerotic cGVHD and persisted until the diagnosis of cGVHD in all patients. Comparison of data with control patients showed that incidence of nail dystrophy, incidence of peripheral edema and mean peak peripheral eosinophil count of patients with skin cGVHD was significantly higher than those without cGVHD. This study suggests that nail dystrophy, persistent peripheral edema and persistent peripheral eosinophilia are harbingers of severe cGVHD of the skin in children. The presence of PIU may be a harbinger of severe lung involvement. |
| doi_str_mv | 10.1038/bmt.2014.194 |
| format | Article |
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Dermatologic examinations were performed in a severe cohort of 11 children with skin cGVHD seen over a 2-year period. Findings were compared with 25 additional patients with skin cGVHD and 97 control patients. In 36 patients with skin cGVHD, nail dystrophy was present in 45% of patients, and was significantly associated with sclerotic disease and lung cGVHD. Pterygium inversum unguis (PIU) was associated with severe lung disease, with significantly lower % predicted FVC and FEV1 in those with PIU than those without. Forty-four percent of GVHD patients had preceding peripheral edema and 56% had preceding peripheral eosinophilia. Peripheral edema and eosinophilia were significantly associated with sclerotic cGVHD and persisted until the diagnosis of cGVHD in all patients. Comparison of data with control patients showed that incidence of nail dystrophy, incidence of peripheral edema and mean peak peripheral eosinophil count of patients with skin cGVHD was significantly higher than those without cGVHD. This study suggests that nail dystrophy, persistent peripheral edema and persistent peripheral eosinophilia are harbingers of severe cGVHD of the skin in children. The presence of PIU may be a harbinger of severe lung involvement.</description><identifier>ISSN: 0268-3369</identifier><identifier>EISSN: 1476-5365</identifier><identifier>DOI: 10.1038/bmt.2014.194</identifier><identifier>PMID: 25243619</identifier><identifier>CODEN: BMTRE9</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>692/699/249/1529 ; 692/700/1720 ; 692/700/1750 ; Adolescent ; Analysis ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Blood diseases ; Bone marrow ; Bone marrow, stem cells transplantation. Graft versus host reaction ; Case-Control Studies ; Cell Biology ; Child ; Children ; Cohort Studies ; Complications and side effects ; Cross-Sectional Studies ; Dropsy ; Dystrophy ; Edema ; Edema - pathology ; Eosinophilia ; Eosinophilia - pathology ; Female ; Graft versus host reaction ; Graft vs Host Disease - diagnosis ; Hematologic and hematopoietic diseases ; Hematology ; Hematopoietic Stem Cell Transplantation - adverse effects ; Humans ; Internal Medicine ; Leukocytes (eosinophilic) ; Lung - pathology ; Lung diseases ; Male ; Medical sciences ; Medicine ; Medicine & Public Health ; Nails - pathology ; original-article ; Other diseases. Hematologic involvement in other diseases ; Physiological aspects ; Public Health ; Risk factors ; Skin ; Skin Diseases - immunology ; Skin Diseases - pathology ; Stem cell transplantation ; Stem Cells ; Transfusions. Complications. Transfusion reactions. Cell and gene therapy ; Transplantation Conditioning ; Transplantation, Homologous - adverse effects ; Treatment Outcome</subject><ispartof>Bone marrow transplantation (Basingstoke), 2014-12, Vol.49 (12), p.1521-1527</ispartof><rights>Macmillan Publishers Limited 2014</rights><rights>2015 INIST-CNRS</rights><rights>COPYRIGHT 2014 Nature Publishing Group</rights><rights>Copyright Nature Publishing Group Dec 2014</rights><rights>Macmillan Publishers Limited 2014.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c720t-77ccf7b808604ddd00317b9122e0142e0afd982d494384b7f1afbe708fed62f43</citedby><cites>FETCH-LOGICAL-c720t-77ccf7b808604ddd00317b9122e0142e0afd982d494384b7f1afbe708fed62f43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1038/bmt.2014.194$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1038/bmt.2014.194$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=29053616$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25243619$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Huang, J T</creatorcontrib><creatorcontrib>Duncan, C N</creatorcontrib><creatorcontrib>Boyer, D</creatorcontrib><creatorcontrib>Khosravi, H</creatorcontrib><creatorcontrib>Lehmann, L E</creatorcontrib><creatorcontrib>Saavedra, A</creatorcontrib><title>Nail dystrophy, edema, and eosinophilia: harbingers of severe chronic GVHD of the skin in children</title><title>Bone marrow transplantation (Basingstoke)</title><addtitle>Bone Marrow Transplant</addtitle><addtitle>Bone Marrow Transplant</addtitle><description>The prognostic value of adnexal findings in chronic GVHD (cGVHD) has not been investigated in children. Dermatologic examinations were performed in a severe cohort of 11 children with skin cGVHD seen over a 2-year period. Findings were compared with 25 additional patients with skin cGVHD and 97 control patients. In 36 patients with skin cGVHD, nail dystrophy was present in 45% of patients, and was significantly associated with sclerotic disease and lung cGVHD. Pterygium inversum unguis (PIU) was associated with severe lung disease, with significantly lower % predicted FVC and FEV1 in those with PIU than those without. Forty-four percent of GVHD patients had preceding peripheral edema and 56% had preceding peripheral eosinophilia. Peripheral edema and eosinophilia were significantly associated with sclerotic cGVHD and persisted until the diagnosis of cGVHD in all patients. Comparison of data with control patients showed that incidence of nail dystrophy, incidence of peripheral edema and mean peak peripheral eosinophil count of patients with skin cGVHD was significantly higher than those without cGVHD. This study suggests that nail dystrophy, persistent peripheral edema and persistent peripheral eosinophilia are harbingers of severe cGVHD of the skin in children. The presence of PIU may be a harbinger of severe lung involvement.</description><subject>692/699/249/1529</subject><subject>692/700/1720</subject><subject>692/700/1750</subject><subject>Adolescent</subject><subject>Analysis</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Blood diseases</subject><subject>Bone marrow</subject><subject>Bone marrow, stem cells transplantation. Graft versus host reaction</subject><subject>Case-Control Studies</subject><subject>Cell Biology</subject><subject>Child</subject><subject>Children</subject><subject>Cohort Studies</subject><subject>Complications and side effects</subject><subject>Cross-Sectional Studies</subject><subject>Dropsy</subject><subject>Dystrophy</subject><subject>Edema</subject><subject>Edema - pathology</subject><subject>Eosinophilia</subject><subject>Eosinophilia - pathology</subject><subject>Female</subject><subject>Graft versus host reaction</subject><subject>Graft vs Host Disease - diagnosis</subject><subject>Hematologic and hematopoietic diseases</subject><subject>Hematology</subject><subject>Hematopoietic Stem Cell Transplantation - adverse effects</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Leukocytes (eosinophilic)</subject><subject>Lung - pathology</subject><subject>Lung diseases</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Nails - pathology</subject><subject>original-article</subject><subject>Other diseases. 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Dermatologic examinations were performed in a severe cohort of 11 children with skin cGVHD seen over a 2-year period. Findings were compared with 25 additional patients with skin cGVHD and 97 control patients. In 36 patients with skin cGVHD, nail dystrophy was present in 45% of patients, and was significantly associated with sclerotic disease and lung cGVHD. Pterygium inversum unguis (PIU) was associated with severe lung disease, with significantly lower % predicted FVC and FEV1 in those with PIU than those without. Forty-four percent of GVHD patients had preceding peripheral edema and 56% had preceding peripheral eosinophilia. Peripheral edema and eosinophilia were significantly associated with sclerotic cGVHD and persisted until the diagnosis of cGVHD in all patients. Comparison of data with control patients showed that incidence of nail dystrophy, incidence of peripheral edema and mean peak peripheral eosinophil count of patients with skin cGVHD was significantly higher than those without cGVHD. This study suggests that nail dystrophy, persistent peripheral edema and persistent peripheral eosinophilia are harbingers of severe cGVHD of the skin in children. The presence of PIU may be a harbinger of severe lung involvement.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>25243619</pmid><doi>10.1038/bmt.2014.194</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| issn | 0268-3369 1476-5365 |
| language | eng |
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| source | MEDLINE; Nature; EZB-FREE-00999 freely available EZB journals; SpringerLink Journals - AutoHoldings |
| subjects | 692/699/249/1529 692/700/1720 692/700/1750 Adolescent Analysis Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Blood diseases Bone marrow Bone marrow, stem cells transplantation. Graft versus host reaction Case-Control Studies Cell Biology Child Children Cohort Studies Complications and side effects Cross-Sectional Studies Dropsy Dystrophy Edema Edema - pathology Eosinophilia Eosinophilia - pathology Female Graft versus host reaction Graft vs Host Disease - diagnosis Hematologic and hematopoietic diseases Hematology Hematopoietic Stem Cell Transplantation - adverse effects Humans Internal Medicine Leukocytes (eosinophilic) Lung - pathology Lung diseases Male Medical sciences Medicine Medicine & Public Health Nails - pathology original-article Other diseases. Hematologic involvement in other diseases Physiological aspects Public Health Risk factors Skin Skin Diseases - immunology Skin Diseases - pathology Stem cell transplantation Stem Cells Transfusions. Complications. Transfusion reactions. Cell and gene therapy Transplantation Conditioning Transplantation, Homologous - adverse effects Treatment Outcome |
| title | Nail dystrophy, edema, and eosinophilia: harbingers of severe chronic GVHD of the skin in children |
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