Hematopoetic stem cell transplantation may be complicated by genital graft-versus-host (GVH) disease and may uncommonly result in labial fusion.
A 22-year-old woman with a history of Ewing’s sarcoma and acute myelogenous leukemia received chemotherapy and total-body irradiation followed by a matched, unrelated donor hematopoetic stem cell transplantation. After transplantation, she developed chronic GVH disease involving the skin, eyes, mouth, and joints. Concomitant vulvar pruritus was presumed to be a fungal infection but, in fact, was genital GVH disease manifesting as labial fusion. Topical estrogen, topical steroids, and surgical division of the labia were successful.
Genital GVH disease should be considered in women with genital tract complaints after hematopoetic stem cell transplantation. Labial fusion secondary to chronic GVH disease may be treated successfully with surgery and medical therapy.
Labial fusion, a rare consequence of graft-versus-host disease, may be treated successfully with surgery and medical therapy.
From the 1Reproductive Biology and Medicine Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
See related case report on page 439.
Corresponding author: Pamela Stratton, MD, NIH, NICHD, RBMB, CRC, Bldg 10, 1E-3140, 10 Center Drive, MSC 1109, Bethesda, MD 20892; e-mail: email@example.com. Supported by the intramural program of the National Institutes of Health Clinical Center, National Institute of Child Health and Human Development, and National Cancer Institute.
Financial Disclosure The authors have no potential conflicts of interest to disclose.