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

Shadi Hamdeh  Abd Almonem M Abdelrahman  Osama Elsallabi  Ranjan Pathak  Smith Giri  Kailash Mosalpuria  Vijaya Raj Bhatt  
【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.

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