Document Detail


Endoscopic Diagnosis of Pediatric Acute Gastrointestinal Graft Versus Host Disease.
MedLine Citation:
PMID:  22367336     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND:: Acute graft-versus-host disease (GVHD) is a major cause of morbidity and mortality in the first 100 days following allogeneic hematopoietic progenitor stem cell transplant (SCT). The best diagnostic endoscopic strategy for gastrointestinal (GI) graft-versus-host disease (GVHD) is a matter of debate. OBJECTIVES:: Our aim in this study was to compare the relative contribution of the endoscopic appearance and biopsies from upper endoscopy and flexible sigmoidoscopy in children with suspected acute GVHD. DESIGN:: Single center retrospective chart review cohort study. METHOD:: We reviewed the charts of all patients younger than 18 years with suspected acute GI GVHD who had endoscopic evaluation within the first 100 days after (SCT) between 1999-2009. RESULTS:: 48 patients were included. The most common symptoms prompting endoscopic evaluation were diarrhea (70%) and a combination of nausea and vomiting (67%). GVHD was diagnosed in at least one biopsy site in 40/48 patients (83%). 22/40 (55%) patients with GVHD had simultaneous upper and lower endoscopic biopsies; 11 patients had only upper endoscopy and 7 had only lower endoscopy. The most common endoscopic finding was normal mucosa. The sensitivity for diagnosing GVHD was 77% for both rectosigmoid and upper endoscopic biopsies. Of 33/40 patients had upper endoscopy with biopsies, 28 (85%) had GVHD. The sensitivities and negative predictive value of gastric biopsies were 85% and 63%, while for duodenal biopsies were 50% and 57% respectively. CONCLUSION:: Rectosigmoid and combined upper endoscopic biopsies are equally sensitive for the diagnosis of acute GI GVHD in children. Flexible sigmoidoscopy can be done unsedated in appropriate patients at the bedside without anesthesia, it can be performed first to identify gastrointestinal GVHD.
Authors:
Mutaz Sultan; Jonathan Ramprasad; M Kyle Jensen; David Margolis; Steven Werlin
Related Documents :
22298086 - Tcrβ clonality improves diagnostic yield of tcrγ clonality in refractory celiac disease.
3997466 - Lymphocytoplasmapheresis in multiple sclerosis: preliminary laboratory findings.
16000626 - Olfactory impairments in patients with unilateral cerebellar lesions are selective to i...
21212566 - Risk factors and prediction of long-term outcome in primary biliary cirrhosis.
11986266 - Ykl-40 is elevated in cerebrospinal fluid from patients with purulent meningitis.
17563646 - Serum b-type natriuretic peptide: a marker of fluid resuscitation after injury?
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-23
Journal Detail:
Title:  Journal of pediatric gastroenterology and nutrition     Volume:  -     ISSN:  1536-4801     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-2-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8211545     Medline TA:  J Pediatr Gastroenterol Nutr     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
*Medical College of Wisconsin, Milwaukee, WI, Divisions of Pediatric Gastroenterology, Hepatology and Nutrition †Medical College of Wisconsin, Milwaukee, WI. Hematology/Oncology and Bone Marrow Transplant.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Determination of pharmaceuticals and antiseptics in water by solid-phase extraction and gas chromato...
Next Document:  Early High Dose Amino Acids for ELBW Infants-Too Early and Too Much?