Filipovich et al developed criteria for the severity of chronic graft-versus-host disease (GVHD) for the National Institutes of Health. One of the criteria involved involvement of the female genital tract.
Patient selection: female with chronic GVHD
Parameters:
(1) gyncologic symptoms
(2) vulvovaginal signs of chronic GVHD
(3) discomfort on gynecologic exam
(4) coitus
|
Parameter |
Finding |
Grade |
|
gynecologic symptoms |
normal |
0 |
|
|
mild |
1 |
|
|
moderate |
2 |
|
|
severe |
3 |
|
vulvovaginal signs |
normal |
0 |
|
|
mild |
1 |
|
|
moderate |
2 |
|
|
severe, stricture, labial fusion, severe ulceration |
3 |
|
discomfort on exam |
none |
0 |
|
|
minimal |
1 |
|
|
mild to moderate |
2 |
|
|
severe, unable to insert vaginal speculum |
3 |
|
Coitus |
normal |
0 |
|
|
mild dyspareunia |
2 |
|
|
severe pain |
3 |
grade for female genital tract involvement =
= MAX(grades for the 4 parameters)
Specialty: Immunology/Rheumatology
