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Endoscopic Findings of Acute Intestinal Graft‐versus‐host Disease after Bone Marrow Transplantation
Author(s) -
EGAWA Naoto,
KATO Hiroaki,
SAKAKI Nobuhiro,
TAJIMA Tsuyoshi,
SAKAMAKI Hisashi,
AKIYAMA Hideki,
TANIKAWA Syu,
KAKU Hidefumi,
HIRUMA Kiyoshi,
KOIKE Morio
Publication year - 1998
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/j.1443-1661.1998.tb00545.x
Subject(s) - medicine , colonoscopy , gastroenterology , ileum , biopsy , enterocolitis , graft versus host disease , transplantation , colorectal cancer , cancer
To clarify the endoscopic findings of intestinal graft‐versus‐host disease (GVHD), we reviewed the endoscopic findings of 19 patients who underwent colonoscopy because of abdominal pain, watery diarrhea or bloody stool among 196 bone marrow transplant (BMT) recipients between 1986 and 1997. BMT had been performed for treatment of various hematopoietic disorders. Eleven patients were diagnosed as having intestinal GVHD, based on the pathological findings of biopsy specimens. Although the grade of inflammation differed among cases, the terminal ileum was most vulnerable to GVHD, based on our observations. Compared to the ileum, findings in the colon tended to be mild. Therefore, evaluation of intestinal GVHD requires observation of the terminal ileum when the colorectal findings are mild. The findings consisted of shallow ulcerations, erythema and easy bleeding. However, there were very few specific endoscopic findings of intestinal GVHD. Since intestinal GVHD and cytomegalovirus (CMV) enterocolitis share several clinical characteristics, including preferential involvement of the ileum, biopsy is indispensable for the final diagnosis.