Rackley Cynthia, Schultz Kirk R, Goldman Frederick D, Chan Ka Wah, Serrano Amy, Hulse James E, Gilman Andrew L
Department of Pediatrics, Children's Memorial Hospital, Chicago, Illinois, USA.
Biol Blood Marrow Transplant. 2005 Oct;11(10):773-80. doi: 10.1016/j.bbmt.2005.07.002.
Graft-versus-host disease (GVHD) is a major cause of morbidity and mortality after bone marrow transplantation. Well-documented manifestations of GVHD include dermatologic, gastrointestinal, hepatic, pulmonary, musculoskeletal, and hematologic manifestations and sicca syndrome. To date, the heart has only rarely been reported to be a target of GVHD. We report a series of patients who developed bradycardia, coronary artery disease, or cardiomyolysis in association with acute or chronic GVHD. The severity of these manifestations ranged from asymptomatic to fatal. The bradycardias were responsive to increased immunosuppression. Although they are uncommon, it is important to recognize these cardiac manifestations, because they may reflect GVHD activity and may be reversible by increasing immunosuppression.
移植物抗宿主病（GVHD）是骨髓移植后发病和死亡的主要原因。GVHD有充分文献记载的表现包括皮肤、胃肠道、肝脏、肺部、肌肉骨骼和血液系统表现以及干燥综合征。迄今为止，心脏很少被报道为GVHD的靶器官。我们报告了一系列与急性或慢性GVHD相关的出现心动过缓、冠状动脉疾病或心肌溶解的患者。这些表现的严重程度从无症状到致命不等。心动过缓对增加免疫抑制有反应。尽管这些情况不常见，但认识到这些心脏表现很重要，因为它们可能反映GVHD的活动，并且通过增加免疫抑制可能是可逆的。
