title: Bowel ultrasonography as an aid for diagnosis of intestinal acute graft-versus-host-disease after allogeneic haematopoietic stem cell transplantation.
abstract: OBJECTIVE
  Aim of our prospective study was to investigate accuracy of bowel ultrasonography in detecting gastrointestinal acute graft versus host disease (GVHD), when using clinical assessment as gold standard. In a subgroup of patients, bowel ultrasonography was compared with colonoscopy and histology in diagnosing of gastrointestinal acute GVHD.
  
  
  METHODS
  Fifty-two patients underwent allogeneic hematopoietic stem cell transplantation and developed gastrointestinal symptoms.
  
  
  RESULTS
  Clinical assessment lead to a diagnosis of gastrointestinal acute GVHD in 17/52 patients, no gastrointestinal acute GVHD was detected in 20/52 patients, while 15 patients were not able to complete the study. Bowel ultrasonography detected either bowel wall thickness of the ileum and the colon or dilation in 16/17 patients and showed 94% sensitivity (95% CI 0.69-0.99), 95% specificity (95% CI 0.73-0.99), and 94.5% accuracy. Colonoscopy was performed in 13/52 patients, showing gastrointestinal acute GVHD in 11/13. In these 11 patients, histology confirmed the diagnosis of gastrointestinal acute GVHD, and bowel ultrasonography detected findings compatible with gastrointestinal acute GVHD in all 11 patients, and was negative in the 2 patients with no gastrointestinal acute GVHD.
  
  
  CONCLUSIONS
  Bowel ultrasonography can be considered a valuable tool to add to clinical assessment for patients with suspected gastrointestinal acute GVHD for addressing a prompt and appropriate treatment.
authors.affiliation: Gastroenterology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Italy. Electronic address: emma.calabrese@uniroma2.it.
authors.forename: Emma
authors.initials: E
authors.lastname: Calabrese
authors.forename: Francesca
authors.initials: F
authors.lastname: Zorzi
authors.forename: Emanuela
authors.initials: E
authors.lastname: Visconti
authors.forename: Gottardo
authors.initials: G
authors.lastname: De Angelis
authors.forename: Raffaella
authors.initials: R
authors.lastname: Cerretti
authors.forename: Giovanna
authors.initials: G
authors.lastname: Del Vecchio Blanco
authors.forename: Alessandra
authors.initials: A
authors.lastname: Picardi
authors.forename: Laura
authors.initials: L
authors.lastname: Cudillo
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Postorino
authors.forename: Luca
authors.initials: L
authors.lastname: Franceschini
authors.forename: Livia
authors.initials: L
authors.lastname: Biancone
authors.forename: William
authors.initials: W
authors.lastname: Arcese
authors.forename: Francesco
authors.initials: F
authors.lastname: Pallone
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D064591:Allografts; D003108:Colonic Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D003113:Colonoscopy; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000000981:diagnostic imaging* / Q000209:etiology; D019337:Hematologic Neoplasms / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D014463:Ultrasonography; D055815:Young Adult
keywords: Accuracy; Endoscopy; Graft versus host disease; Sensitivity; Specificity; Ultrasonography