Department of Internal Medicine, Regional University Hospital-Claude Huriez Hospital, Lille, France.
Clin Rheumatol. 2010 Apr;29(4):431-33. doi: 10.1007/s10067-009-1350-5.
Chronic graft-versus-host disease (GVHD) sometimes mimics autoimmune diseases. We report the case of a 39-year-old patient who presented atypical polymyositis without elevated creatinine phosphokinase, related to a chronic GVHD following interruption of immunosuppressive treatment. Treatment with cyclosporine and corticosteroids resulted in complete and sustained remission of the polymyositis. The symptoms of chronic GVHD-related polymyositis are indistinguishable from those of idiopathic polymyositis. The context of transplantation and a decrease or interruption of prophylaxis suggest the diagnosis of GVHD-related polymyositis, especially if other manifestations of GVHD are associated. A suitably adapted treatment (association of corticotherapy and cyclosporine) improves polymyositis, and in most cases, a normal clinical state is achieved even if the symptoms were severe.
慢性移植物抗宿主病（GVHD）有时类似于自身免疫性疾病。我们报告了一例 39 岁患者，其表现为非典型性多发性肌炎，肌酸磷酸激酶不高，与免疫抑制治疗中断后发生的慢性 GVHD 有关。环孢素和皮质类固醇治疗导致多发性肌炎完全和持续缓解。慢性 GVHD 相关多发性肌炎的症状与特发性多发性肌炎无法区分。移植背景和预防治疗的减少或中断提示 GVHD 相关多发性肌炎的诊断，尤其是如果伴有其他 GVHD 表现。适当的治疗（皮质激素治疗和环孢素联合治疗）可改善多发性肌炎，并且在大多数情况下，即使症状严重，也可达到正常的临床状态。
