Endoscopic diagnosis of gastrointestinal graft-versus-host disease

• 作 者: Chun-Fang Xu Lan-Xiang Zhu Xiao-Ming Xu Wei-Chang Chen De-Pei Wu
• 机 构: Department of Gastroenterology, The First Affiliated Hospital of SooChow University, 188 Shizi Stree
• 出 处: 世界胃肠病学杂志（英文版）
• 发表日期: 2008年14期
• 关键词: Gastrointestinal graft-versus-host disease Endoscopy Diagnosis Allogeneic hemato

AIM: To evaluate the diagnostic value of endoscopy in patients with gastrointestinal graft-versus-host disease (GI GVHD).METHODS: We identified 8 patients with GI GVHD following allogeneic hematopoietic stem cell transplantation (HSCT). GVHD was defined histologically as the presence of gland apoptosis, not explained by other inflammatory or infectious etiologies.RESULTS: The symptoms of GI GVHD included anorexia,nausea, vomiting, watery diarrhea, abdominal pain, GI bleeding, etc. Upper endoscopic appearance varied from subtle mucosal edema, hyperemia, erythema to obvious erosion. Colonoscopic examination showed diffuse edema, hyperemia, patchy erosion, scattered ulcer,sloughing and active bleeding. Histological changes in GI GVHD included apoptosis of crypt epithelial cells, dropout of crypts, and lymphocytic infiltration in epithelium and lamina propria. The involvement of stomach and rectocolon varied from diffuse to focal.CONCLUSION: Endoscopy may play a significant role in early diagnosis of GI GVHD patients following allogeneic HSCT, and histologic examination of gastrointestinal biopsies is needed to confirm the final diagnosis.