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Tongue graft-versus-host disease: remission with ruxolitinib
  1. Katerina Grafanaki1,
  2. Spyridon Lygeros2,
  3. Alexandros Spyridonidis3 and
  4. Maria Liga3
  1. 1Department of Dermatology, University Hospital of Patras, School of Medicine, Patras, Rion, Greece
  2. 2Ear, Nose, Throat Department, University General Hospital of Patras, Patras, Rion, Greece
  3. 3Bone Marrow Transplantation Unit, Department of Internal Medicine, University Hospital of Patras, Rion, Greece
  1. Correspondence to Dr Katerina Grafanaki; grafanaki{at}med.upatras.gr

Abstract

Graft-versus-host disease (GvHD) is a potentially life-threatening and commonly encountered event of allogeneic haematopoietic stem cell transplantation. Here, we present a young adult male with primary refractory Hodgkin’s lymphoma who received a transplant and developed cutaneous GvHD after donor lymphocyte infusion, which was managed with cyclosporine and steroids. However, while the patient was under immunosuppressive treatment, diffuse confluent whitish patches on the patient’s tongue were observed. A biopsy of the tongue lesions revealed lichenoid, hyperkeratotic tissue changes and intraepithelial T-cell infiltration consistent with chronic GvHD. He was treated with mycophenolate mofetil for 6 months with minimal improvement. Janus-associated kinase inhibitor (ruxolitinib) treatment was commenced, with complete resolution of the tongue lesions and treatment discontinuation 5 months later. Currently, 5 years after allogeneic transplantation, he is in remission and does not need immunosuppressive therapy.

  • Dermatology
  • Haematology (incl blood transfusion)
  • Mouth
  • Transplantation

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Footnotes

  • Contributors ML and AS were responsible for the clinical management of the patient. SL and KG contributed to the clinical diagnosis of tongue GvHD. All authors contributed to the conceptualisation, writing and reviewing of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.