Graft Versus Host Disease (GVHD) Symptoms

September 27, 2024
This page was reviewed under our medical and editorial policy by Leslie Popplewell, M.D., Hematologist and Medical Director of Hematology and Blood and Bone Marrow Transplant, City of Hope^® Atlanta

The symptoms that a patient may develop from graft versus host disease (GVHD) vary depending on where they occur and whether the patient has acute or chronic GVHD.

Following are some symptoms that may occur in various locations of the body.

Skin GVHD Symptoms

Skin symptoms are typically the first sign that a patient may be experiencing graft versus host disease. They may include those listed below.

Acute

• Redness of palms and feet
• Rash covering parts of the body
• Sensitive, itching or dry skin

Chronic

• Rash covering parts of the body
• Darkened and dry skin
• Peeling skin
• Bumpy, thick skin

What a GVHD Rash Looks Like

A GVHD rash may appear anywhere on the body, and often looks like sunburn. It typically starts with a pale red color in one area (such as the palms of the hands) and may spread to other areas as well. If a GVHD rash is severe, it may cause the skin to peel or blister. 

GVHD Gut Symptoms

When GVHD affects the gastrointestinal (GI) tract, symptoms may include those listed below.

Acute 

• Diarrhea
• Nausea
• Loss of appetite
• Abdominal cramps
• Vomiting 

Chronic 

• Diarrhea
• Weight loss
• Difficulty eating
• Loss of appetite
• Vomiting

GVHD Liver Symptoms

If GVHD affects the liver, it may not cause any symptoms and may be detected on a blood test. When symptoms do occur, they may include those listed below.

Acute 

• Jaundice (yellowing of the eyes or skin)
• Abdominal swelling
• Abdominal tenderness

Chronic 

• Swelling in the abdomen
• Jaundice
• Abdominal tenderness

GVHD Lung Symptoms

In some cases of chronic GVHD, the lungs may be affected. Although this won’t always cause symptoms, when they do occur, they may include the signs listed below.

• Difficulty taking deep breaths
• Shortness of breath
• A dry cough that persists
• Wheezing 
• Chest tightness

GVHD Eye Symptoms

When graft versus host disease affects the eyes, it’s referred to as ocular GVHD. This typically impacts those with chronic GVHD and not the acute form of the disease. These symptoms may include those listed below.

• Dry eyes
• Sensitivity to light
• Blurred vision
• Pain in the eyes
• Eye redness

GVHD Mouth Symptoms

Chronic graft versus host disease can cause mouth symptoms, also referred to as oral GVHD. The symptoms may include:

• Dry mouth
• Mouth sores
• Difficulty swallowing and eating
• Tooth and gum disease

GVHD Genital Symptoms

Chronic GVHD may affect the genitals, potentially causing these symptoms:

• Vaginal dryness, irritation, pain or itching
• Itching, scarring or irritation of the penis and scrotum
• Painful intercourse

Other Chronic GVHD Signs

In some instances, chronic GVHD may affect the muscles and joints, causing weakness, cramps or stiffness in areas like the elbows, ankles, fingers or knees. 

It can also affect the hair and scalp, causing premature graying or loss of hair on the body or head. 

Some people notice changes in their nails, with fingernails or toenails that become hard, brittle or textured. The nails may also fall off. 

Contact the care team immediately if any of these GVHD symptoms occur to ensure they evaluate the issue and provide treatment as soon as possible.