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Warning-sign checks

Graft-versus-host disease: when to get help

Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.

  1. 1

    Is any of this happening now?

    Call 911

    Seek emergency care for severe difficulty breathing, chest pain, fainting, confusion, uncontrolled bleeding, severe dehydration, or widespread blistering or peeling skin.

    If possible, tell emergency staff that you have had an allogeneic stem cell transplant and may be taking immune-suppressing medicines.

    Other emergency signs, for anyone
    • Someone who is struggling to breathe, gasping, choking, or cannot get words out
    • Someone who has chest pain, tightness or pressure lasting more than a few minutes
    • Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
    • Someone who is unconscious, or cannot be woken
    • Someone who is bleeding heavily and it will not stop with firm pressure
    • Someone who has had a seizure that will not stop, or does not wake up afterwards
    • Someone who has lips or skin that look pale, blue, grey or blotchy
    • Someone who you believe has taken an overdose or swallowed something poisonous
  2. 2

    Is any of this happening?

    Be seen today

    Contact your transplant team promptly about any new rash, diarrhea, vomiting, jaundice, mouth soreness, eye discomfort, cough, breathlessness, genital pain, reduced joint movement, or unexpected weight loss.

    Prompt contact is also important if known GVHD worsens or if prescribed medicines cannot be taken.

    Seek urgent medical advice for frequent watery diarrhea, inability to keep fluids down, rapidly spreading rash, new yellowing of the skin or eyes, worsening breathlessness, or signs of infection such as fever or shaking chills.

    Follow the specific fever plan given by your transplant centre.

  3. 3

    Does any of this apply?

    Book an appointment

    Routine follow-up remains important even when symptoms are stable.

    Some lung, eye, liver, or mouth changes can develop gradually and may be found during monitoring.

Every sign above is quoted from the sofidex article on Graft-versus-host disease. If you are not sure, err upward — it is always reasonable to be checked.