title: Endoscopic diagnosis of gastrointestinal graft-versus-host disease.
abstract: OBJECTIVE
  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 trans-plantation (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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Gastroenterology, The First Affiliated Hospital of SooChow University, Suzhou 215006, China. xcf601@163.com
authors.forename: Chun-Fang
authors.initials: CF
authors.lastname: Xu
authors.forename: Lan-Xiang
authors.initials: LX
authors.lastname: Zhu
authors.forename: Xiao-Ming
authors.initials: XM
authors.lastname: Xu
authors.forename: Wei-Chang
authors.initials: WC
authors.lastname: Chen
authors.forename: De-Pei
authors.initials: DP
authors.lastname: Wu
mesh_terms: D000328:Adult; D017209:Apoptosis; D001706:Biopsy; D003113:Colonoscopy / Q000379:methods; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005762:Gastroenterology / Q000379:methods; D041981:Gastrointestinal Tract / Q000276:immunology / Q000473:pathology*; D006086:Graft vs Host Disease / Q000175:diagnosis*; D006801:Humans; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D013234:Stem Cells / Q000166:cytology; D014184:Transplantation, Homologous