Rapid Improvement in Jaundice Using Transdermal Isosorbide Tape as a Nitric Oxide Donor in Two Adult Patients with Transplantation-associated Microangiopathy Related to Graft-versus-host Disease

• Published in: Internal Medicine Vol. 61; no. 8; pp. 1225 - 1230
• Main Authors: Hiroshima, Yuki, Sato, Keijiro, Ueki, Toshimitsu, Sumi, Masahiko, Ueno, Mayumi, Ichikawa, Naoaki, Satomi, Hidetoshi, Kobayashi, Hikaru
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 15.04.2022; Japan Science and Technology Agency
• Subjects: Bilirubin; Case Report; endothelial cell injury; Graft versus host disease; graft-versus-host disease (GVHD); Graft-versus-host reaction; Internal medicine; Jaundice; liver dysfunction; Nitric oxide; nitric oxide donor (NO donor); transdermal isosorbide tape; Transplantation; transplantation-associated microangiopathy (TAM); endothelial cell injury; nitric oxide donor (NO donor); transplantation-associated microangiopathy (TAM); graft-versus-host disease (GVHD); liver dysfunction; transdermal isosorbide tape
• ISSN: 0918-2918; 1349-7235; 1349-7235
• DOI: 10.2169/internalmedicine.7789-21

Two adult patients with acute leukemia developed transplantation-associated microangiopathy (TAM) related to graft-versus-host disease (GVHD). Both patients were resistant to standard therapy for TAM and GVHD, which led to markedly elevated serum total bilirubin levels of 47.5 and 10.6 mg/dL, respectively. Transdermal isosorbide tape as a nitric oxide donor was applied to Patients 1 and 2 on post-transplantation days 60 and 66, respectively, which rapidly improved their jaundice after 1 day. This is the first report to describe the efficacy of transdermal isosorbide tape for adult patients with jaundice associated with TAM related to GVHD.