Document Detail


Etiology and outcome of diarrhea after marrow transplantation: a prospective study.
MedLine Citation:
PMID:  7926504     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/AIMS: Acute diarrhea after marrow transplant is usually ascribed to acute graft-vs.-host disease (GVHD) or infection, with a reported 40%-50% incidence of infection. The aim of this study was to determine the incidence of acute diarrhea after transplantation, its causes, and its outcome. METHODS: Two hundred ninety-six patients were followed up; patients with diarrhea were studied using standard evaluation of stool plus immunoelectron microscopy; assays for astrovirus, picobirnavirus, and Norwalk virus; and gene-probe methods for toxin-producing Escherichia coli. In 38 patients with diarrhea, intestinal biopsy specimens and duodenal fluid were also analyzed. RESULTS: One hundred fifty acute diarrheal episodes developed in 126 patients (an incidence of 43%). Intestinal infection was found in 20 of 150 episodes: viruses (astrovirus, adenovirus, cytomegalovirus, and rotavirus) in 12 patients, nosocomially acquired bacteria (Clostridium difficile and Aeromonas) in 7 patients, and mixed infection in 1 patient. Acute GVHD was responsible for 72 of 150 episodes (48%). Clinical signs and symptoms of infection and GVHD were similar. In 58 of 150 episodes (39%), no clear etiology could be found for self-limited diarrhea. CONCLUSIONS: Intestinal infection accounted for 13% and acute GVHD for 48% of diarrheal episodes. The most common infecting organisms were astrovirus, C. difficile, and adenovirus. Most cases of diarrhea after marrow transplant are not caused by infection.
Authors:
G J Cox; S M Matsui; R S Lo; M Hinds; R A Bowden; R C Hackman; W G Meyer; M Mori; P I Tarr; L S Oshiro
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Gastroenterology     Volume:  107     ISSN:  0016-5085     ISO Abbreviation:  Gastroenterology     Publication Date:  1994 Nov 
Date Detail:
Created Date:  1994-11-22     Completed Date:  1994-11-22     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0374630     Medline TA:  Gastroenterology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1398-407     Citation Subset:  AIM; IM    
Affiliation:
Fred Hutchinson Cancer Research Center, Seattle, Washington.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adenovirus Infections, Human / complications
Adult
Bacterial Infections / complications
Bone Marrow Transplantation*
Chi-Square Distribution
Diarrhea / epidemiology,  etiology*
Female
Follow-Up Studies
Graft vs Host Disease / complications
Humans
Incidence
Male
Mamastrovirus
Middle Aged
Prognosis
Prospective Studies
Virus Diseases / complications
Grant Support
ID/Acronym/Agency:
CA 18029/CA/NCI NIH HHS; CA15704/CA/NCI NIH HHS; DK38707/DK/NIDDK NIH HHS

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