The Role of Endoscopic Evaluation in Patients with Suspected Intestinal Graft-Versus-Host Disease After Allogeneic Bone-Marrow Transplantation

Terdiman, Jonathan P.; Linker, Charles; Ries, Curt A.; Damon, Lloyd E.; Rugo, HS; Ostroff, James W.

doi:10.1055/s-2007-1005576

Cited by 46 publications

(35 citation statements)

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“…Despite the limited data available in the literature, CE should now be reg arded as an alter native to esogastroduodenoscopy in the workup of patients with suspected GVHD, particularly in critically ill patients requiring quick therapeutic decisions. Indeed, CE appears to be as effective as esogastroduodenoscopy with biopsy for the diagnosis of acute GVHD [25][26][27] .…”

Section: Immunological Digestive Disorders (Photo N° 9 Et 10) (Maladimentioning

confidence: 99%

Capsule endoscopy in non-steroidal anti-inflammatory drugs-enteropathy and miscellaneous, rare intestinal diseases

Gay¹,

Delvaux²,

Frederic³

2008

WJG

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Despite significant advances over the last decade, mucosal lesions of the small bowel are poorly detected by imaging studies such as CT scan, MRI-enteroclysis and contrast-enhanced abdominal ultrasound. Capsule endoscopy (CE) has dramatically changed the diagnostic approach to intestinal diseases. Moreover, the use of CE can be extended to include other conditions. However, it is difficult to assess the positive influence of CE on patient outcomes in conditions involving a small number of patients, or in critically ill and difficult to examine patients. CE has the advantage of diagnosing intestinal lesions and of directing the use of double balloon enteroscopy (DBE) in order to obtain biopsy specimens. Moreover, CE allows repeated assessment in chronic conditions, especially to detect relapse of an infectious disease.

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Section: Immunological Digestive Disorders (Photo N° 9 Et 10) (Maladimentioning

confidence: 99%

Capsule endoscopy in non-steroidal anti-inflammatory drugs-enteropathy and miscellaneous, rare intestinal diseases

Gay¹,

Delvaux²,

Frederic³

2008

WJG

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“…Endoscopy combined with tissue biopsy is usually required to establish the diagnosis of acute GI GVHD. In a retrospective study, Terdiman and colleague [25] confirmed that acute upper GI GVHD is sensitive to many drugs if early diagnosis could be properly made. While treatment fails, upper GI GVHD may progress to lower GI.…”

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confidence: 97%

Endoscopic diagnosis of gastrointestinal graft-versus-host disease

Xu¹,

Zhu²,

Xu³

et al. 2008

WJG

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“…Up to one-half of SCT patients have been reported to have gastrointestinal symptoms severe enough to warrant evaluation by endoscopy. 1 Approximately 10-50% of patients with a sibling donor 2,3 and 68% of those with a matched, unrelated donor (URD) 3 develop acute graft-versus-host disease (GVHD). The gastrointestinal tract is one of the principal target organs of GVHD.…”

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confidence: 99%

Increased cell turnover, but no signs of increased T-cell infiltration or inflammatory cytokines in the duodenum of pediatric patients after allogeneic stem cell transplantation

Taskinen

Westerholm-Ormio

Karikoski

et al. 2004

Bone Marrow Transplant

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Summary:Intestinal immunopathology was studied after allogeneic stem cell transplantation (SCT) in a common clinical setup in 20 children with malignant (n ¼ 17) or nonmalignant diseases (n ¼ 3) receiving grafts from siblings (7) and unrelated donors (13). In all, 19 had total body irradiation. Duodenal biopsies at 6 and 12 weeks post transplant were evaluated by histology, immunohistochemistry, and ISEL for the detection of T-lymphocytes, inflammatory cytokines, proliferation, and apoptosis. The controls were 12 healthy children and three patients with proven intestinal graft-versus-host disease. An increased rate of apoptosis and proliferation with upregulated expression of HLA-DR antigen was detected up to 3 months post transplant in the SCT patients, even in those with a histologically normal small intestine. A low level of IFNc and TNFa was observed in the lamina propria. The initial low density of cd-positive T cells had recovered to normal by the time of the second endoscopy at 12 weeks post transplant. We conclude that inflammatory activity and T cell infiltration detected by immunohistochemistry may not belong to the 'normal' recovery of the small intestine after SCT. Increased cell turnover in the intestinal crypts continues until 3 months after SCT, suggesting either an unexpectedly long-lasting effect of transplant-related toxicity or, preferably, an ongoing subclinical alloreactive process, also present in the patients without intestinal symptoms.

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The Role of Endoscopic Evaluation in Patients with Suspected Intestinal Graft-Versus-Host Disease After Allogeneic Bone-Marrow Transplantation

Cited by 46 publications

References 0 publications

Capsule endoscopy in non-steroidal anti-inflammatory drugs-enteropathy and miscellaneous, rare intestinal diseases

Capsule endoscopy in non-steroidal anti-inflammatory drugs-enteropathy and miscellaneous, rare intestinal diseases

Endoscopic diagnosis of gastrointestinal graft-versus-host disease

Increased cell turnover, but no signs of increased T-cell infiltration or inflammatory cytokines in the duodenum of pediatric patients after allogeneic stem cell transplantation

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