Endoscopic findings predict the histologic diagnosis in gastrointestinal graft-versus-host disease

M. Cruz-Correa, A. Poonawala, S. C. Abraham, T. T. Wu, M. Zahurak, G. Vogelsang, A. N. Kalloo, L. A. Lee

Research output: Contribution to journalArticle

57 Scopus citations

Abstract

Background and study aims: Graft-versus-host disease (GvHD) of the gastrointestinal tract is a major cause of morbidity and mortality after allogeneic bone marrow transplantation (BMT). Whether endoscopic findings predict the histologic diagnosis of GvHD in the gastrointestinal tract remains controversial. We performed a study to determine the diagnostic accuracy of macroscopic endoscopy findings in the diagnosis of acute and chronic histologically proven gastrointestinal GvHD (GI-GvHD). Patients and methods: Endoscopic images from the intestinal mucosa of post-BMT patients were blindly graded as positive or negative for GI-GvHD and compared with corresponding histological findings, which were used as the gold standard. Results: 44 BMT patients were referred for 96 endoscopic evaluations. Using 162 endoscopy-biopsy pairs, a positive association between endoscopic grading and histologic grading of GI-GvHD (odds ratio [OR]=11.97, 95% CI 3.86, 37.16) was observed. Endoscopic diagnosis correctly predicted histologic diagnosis in both acute and chronic GI-GvHD (OR = 9.3 vs. 23.1, P = 0.31). Conclusions: The diagnostic accuracy of endoscopy was high in both acute and chronic histologically proven GI-GvHD. Accurate diagnosis of GI-GvHD might be obtained with mucosal biopsies from either the upper or lower gastrointestinal tract. Endoscopy may play a significant role in establishing early diagnosis and treatment for GI-GvHD in patients following BMT, but histologic evaluation of the gastrointestinal mucosa is needed to confirm the final diagnosis.

Original languageEnglish (US)
Pages (from-to)808-813
Number of pages6
JournalEndoscopy
Volume34
Issue number10
DOIs
StatePublished - Oct 1 2002

ASJC Scopus subject areas

  • Gastroenterology

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    Cruz-Correa, M., Poonawala, A., Abraham, S. C., Wu, T. T., Zahurak, M., Vogelsang, G., Kalloo, A. N., & Lee, L. A. (2002). Endoscopic findings predict the histologic diagnosis in gastrointestinal graft-versus-host disease. Endoscopy, 34(10), 808-813. https://doi.org/10.1055/s-2002-34257