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

作     者：Shadi Hamdeh Abd Almonem M Abdelrahman Osama Elsallabi Ranjan Pathak Smith Giri Kailash Mosalpuria Vijaya Raj Bhatt 

作者机构：Department of Internal Medicine Creighton University School of Medicine Department of Medicine Reading Health System Reading Department of Medicine University of Tennessee Health Science Center Department of Internal Medicine Division of Hematology-Oncology University of Nebraska Medical Center 

出 版 物：《World Journal of Hematology》 (世界血液学杂志)

年 卷 期：2016年第5卷第1期

页      面：23-30页

学科分类：10[医学] 

主　　题：Diarrhea Medication-induced diarrhea Allogeneic hematopoietic stem cell transplant Enteric infection Graft-vs-host disease 

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.