Clinical approach to diarrheal disorders in allogeneic hematopoietic stem cell transplant recipients

• 作者: Abd Almonem M Abdelrahman Kailash Mosalpuria Osama Elsallabi Ranjan Pathak Shadi Hamdeh Smith Giri Vijaya Raj Bhatt
• 来源期刊: 世界血液学杂志
• 学科: 医学
• 关键词: DIARRHEA Medication-induced DIARRHEA ALLOGENEIC HEMATOPOIETIC stem cell transplant ENTERIC infection Graft-vs-host disease
• 年，卷（期）: 2016,（1）
• 页码范围: 23-30
• 页数: 8页
• 分类号: R

摘要

Diarrhea is a common complication of allogeneic hematopoietic stem cell transplant(HSCT),with an average incidence of approximately 40%-50%.A wide variety of etiologies can contribute to diarrhea in HSCT patients,including medication-induced mucosal inflammation,infections,graft-vs-host disease and cord colitis syndrome in umbilical cord blood transplant.Clinical manifestations can vary from isolated diarrheal episodes,to other organ involvement including pneumonia or myocarditis,and rarely multiorgan failure.The approach for diagnosis of diarrheal disorders in HSCT patients depends on the most likely cause.Given the risk of life-threatening conditions,the development of clinically significant diarrhea requires prompt evaluation,supportive care and specific therapy,as indicated.Serious metabolic and nutritional disturbances can happen in HSCT patients,and may even lead to mortality.In this review,we aim to provide a practical approach to diagnosis and management of diarrhea in the post-transplant period.