Endoscopic evaluation of acute intestinal graft-versus-host disease after allogeneic hematopoietic cell transplantation.
Turk J Gastroenterol
; 27(4): 312-6, 2016 Jul.
Article
em En
| MEDLINE
| ID: mdl-27458845
ABSTRACT
BACKGROUND/AIMS:
Acute graft-versus-host disease (GVHD) is a common complication of haematopoietic cell transplantation (HCT), with the gastrointestinal tract (GIT) as one of the main target organs. There is a lack of consensus regarding the site in GIT with the highest sensitivity for biopsy. The present study aimed to determine the endoscopic and histological findings in acute GVHD. MATERIALS ANDMETHODS:
The data of 111 patients who had received allogeneic HCT were retrospectively reviewed.RESULTS:
Allogeneic HCT was performed in 111 patients, of whom 27 (24.3%) had developed acute GVHD. Nineteen of the 111 patients with intestinal symptoms were evaluated for intestinal involvement, and 17 were diagnosed with acute intestinal GVHD. Upper endoscopic findings had a sensitivity of 64.7%, a specificity of 50%, a positive predictive value of 91.6% and a negative predictive value of 14.2%. The diagnostic accuracy of upper endoscopy was 63.1%. Lower endoscopic findings had a sensitivity of 40% and a specificity of 0%. The diagnostic accuracy of upper endoscopy with duodenal biopsy and sigmoidoscopy was 94.1%.CONCLUSION:
Endoscopic findings are nonspecific in acute intestinal GVHD. There is little agreement between endoscopic findings and histopathology; thus, biopsies are essential. In patients with intestinal symptoms after HCT, upper endoscopy with duodenal biopsy and sigmoidoscopy has an acceptable diagnostic yield for intestinal involvement.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Endoscopia Gastrointestinal
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Transplante de Células-Tronco Hematopoéticas
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Doença Enxerto-Hospedeiro
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Enteropatias
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Evaluation_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article