Obstet Gynecol Sci.  2013 Jul;56(4):277-280.

Gynecologic complication of chronic graft-versus-host disease: Vaginal obstruction

• Park J
• Kim TH
• Lee HH
• Chung SH
• Lee D

Abstract

Allogenic peripheral blood stem cell transplantation (Allo-PBSCT) is being used to treat hematological malignancies with increasing frequency. Graft-versus-host disease (GvHD) is a complex complication of PBSCT. A 43-year-old woman came to the gynecology clinic for amenorrhea. She had been diagnosed with acute myeloid leukemia 2 years earlier and treated with induction and consolidation chemotherapy. After developing complete remission, she underwent Allo-PBSCT. When she started chemotherapy, her menstrual cycle completely disappeared. Fourteen months after menopausal hormone replacement therapy, it was discovered that her upper vaginal canal was completely obstructed. The lower vagina had an atrophic appearance. We report a rare case of partial vaginal obstruction as a complication of chronic GvHD and review the literature. We expect that this case report provides an opportunity to remind clinician of the gynecologic complications of GvHD.

Keyword

Graft vs host disease; Hematocolpos; Peripheral blood stem cell transplantation; Vagina

MeSH Terms

Amenorrhea
Consolidation Chemotherapy
Female
Graft vs Host Disease
Gynecology
Hematocolpos
Hematologic Neoplasms
Hormone Replacement Therapy
Humans
Leukemia, Myeloid, Acute
Menstrual Cycle
Peripheral Blood Stem Cell Transplantation
Porphyrins
Vagina
Porphyrins

Figure

• 

  Fig. 1 (A) Before allogenic peripheral blood stem cell transplantation, photograph shows normal uterine cervix with intra-uterine device tail string which got stuck into exocervix. (B) Twenty-six months after allogenic peripheral blood stem cell transplantation, photograph shows almost complete obstruction of the upper vaginal canal. A lower vagina had normal appearance. (C) Twenty-six months after allogenic peripheral blood stem cell transplantation, trans-rectal ultrasonography shows hematocolpos (arrow). asterisk, uterine cervix; star, vagina.

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