title: Short article: Etiologic profile and endoscopic findings in immunocompromised children and adolescents with gastrointestinal bleeding.
abstract: BACKGROUND
  Gastrointestinal bleeding (GIB) is one of the potential causes of increased morbidity and mortality in immunocompromised patients, but data on characteristics of GIB in immunocompromised children are sparse.
  
  
  OBJECTIVE
  This study aimed to identify the etiology, endoscopic, and histologic findings of GIB in immunocompromised children.
  
  
  METHODS
  This was a retrospective descriptive study.
  
  
  METHODS
  We identified 33 patients (aged<20 years) and 45 GIB episodes related to GIB between January 2007 and April 2015 from a tertiary care and teaching hospital.
  
  
  RESULTS
  The mean age at endoscopy was 10.7±4.6 years. Most common indications for endoscopy were melena in upper GIB and hematochezia in lower GIB. The median delay of duration between GIB presentation to endoscopy was 3 days. All except one child had at least one endoscopic abnormality. The most common cause of upper GIB was cytomegalovirus (CMV)-related gastrointestinal disease (35%), followed by esophageal varices (26%), and the most common cause of lower GIB was CMV-related gastrointestinal disease (55%). Fourteen percent of patients died during upper GIB episodes and 15% died during lower GIB episodes.
  
  
  CONCLUSIONS
  Among immunocompromised individuals aged younger than 20 years presenting with GIB, CMV-related gastrointestinal disease is the most prevalent in our study population. However, the etiology of immunocompromised state needs to be taken into consideration when evaluating these children presenting with GIB.
authors.affiliation: aDepartment of Pediatrics, University of South Alabama, Mobile, Alabama, USA bDepartment of Pediatrics, Division of Gastroenterology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Chaowapong
authors.initials: C
authors.lastname: Jarasvaraparn
authors.forename: Pornthep
authors.initials: P
authors.lastname: Tanpowpong
authors.forename: Chatmanee
authors.initials: C
authors.lastname: Lertudomphonwanit
authors.forename: Suporn
authors.initials: S
authors.lastname: Treepongkaruna
mesh_terms: D000293:Adolescent; D001202:Ascitic Fluid / Q000382:microbiology; D002648:Child; D003586:Cytomegalovirus Infections / Q000150:complications / Q000175:diagnosis / Q000276:immunology; D004269:DNA, Bacterial / Q000032:analysis; D016099:Endoscopy, Gastrointestinal; D004932:Esophageal and Gastric Varices / Q000150:complications; D005260:Female; D005767:Gastrointestinal Diseases / Q000150:complications / Q000175:diagnosis / Q000276:immunology; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology; D006086:Graft vs Host Disease / Q000150:complications / Q000175:diagnosis / Q000276:immunology; D006801:Humans; D016867:Immunocompromised Host; D053208:Kaplan-Meier Estimate; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D004269:DNA, Bacterial