Endoscopic diagnosis of gastrointestinal graft-versus-host disease.
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.
Xu
Chun-Fang
CF
Department of Gastroenterology, The First Affiliated Hospital of SooChow University, Suzhou 215006, China. xcf601@163.com
Zhu
Lan-Xiang
LX
Xu
Xiao-Ming
XM
Chen
Wei-Chang
WC
Wu
De-Pei
DP
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