AI Summary & Key Takeaways
AI InsightIn patients with intestinal symptoms after HCT, upper endoscopy with duodenal biopsy and sigmoidoscopy has an acceptable diagnostic yield for intestinal involvement
📌 3 Key Takeaways
Özet
Acute graft-versus-host disease (GVHD) is a common complication of haematopoietic cell transplantation (HCT), with the gastrointestinal tract (GIT) as one of the main target organs. There is a lack of consensus regarding the site in GIT with the highest sensitivity for biopsy. The present study aimed to determine the endoscopic and histological findings in acute GVHD.Materials and Methods: The data of 111 patients who had received allogeneic HCT were retrospectively reviewed.Results: Allogeneic HCT was performed in 111 patients, of whom 27 (24.3%) had developed acute GVHD. Nineteen of the 111 patients with intestinal symptoms were evaluated for intestinal involvement, and 17 were diagnosed with acute intestinal GVHD. Upper endoscopic findings had a sensitivity of 64.7%, a specificity of 50%, a positive predictive value of 91.6% and a negative predictive value of 14.2%. The diagnostic accuracy of upper endoscopy was 63.1%. Lower endoscopic findings had a sensitivity of 40% and a specificity of 0%. The diagnostic accuracy of upper endoscopy with duodenal biopsy and sigmoidoscopy was 94.1%.Conclusion: Endoscopic findings are nonspecific in acute intestinal GVHD. There is little agreement between endoscopic findings and histopathology; thus, biopsies are essential. In patients with intestinal symptoms after HCT, upper endoscopy with duodenal biopsy and sigmoidoscopy has an acceptable diagnostic yield for intestinal involvement