Endoscopic Approach in the Diagnosis of Gastrointestinal Acute Graft Versus Host Disease in Children

JPGN reports · 7 authors, 3 centres

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It found that histological confirmation of the disease was associated with a significantly higher risk of steroid resistance and transplant-related mortality.

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This was a retrospective observational study of 26 children who underwent gastrointestinal endoscopy for suspected acute graft-versus-host disease between 2000 and 2017. The study found the endoscopic approach to be feasible and safe, with only one complication (duodenal hematoma) reported. The authors conclude that histological diagnosis identifies a higher-risk subgroup. Key limitations include the retrospective design and the fact that not all clinically suspected cases underwent endoscopy, which may affect the assessment of diagnostic performance.

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cohort

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pediatrics

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ORIGINAL PAPER

PMC10158456

Endoscopic Approach in the Diagnosis of Gastrointestinal Acute Graft Versus Host Disease in Children

JPGN reports

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ABSTRACT

Objectives: The objectives of this study were to describe clinical, histological, and endoscopic findings in children undergoing gastrointestinal (GI) endoscopy for symptoms of digestive acute graft-versus-host disease (a-GvHD), to evaluate the rate of steroid-resistant GvHD and transplant-related mortality, and to describe the feasibility and safety of the endoscopic procedure. Methods: This was a retrospective study conducted, at the IRCSS Istituto G. Gaslini in Genova, Italy, in 26 children undergoing upper or lower GI endoscopy after allogeneic hematopoietic stem cell transplantation between 2000 and 2017. Results: Histology confirmed a diagnosis of a-GvHD in 73% of patients; it was frequently associated with steroid-resistant a-GvHD ( P = 0.001) and with an increased transplant-related mortality. Additionally, one patient developed duodenal hematoma after endoscopy for a high-grade GI a-GvHD. Conclusions: In our experience, the endoscopic approach in the diagnosis of GI a-GvHD in children was feasible and safe. Furthermore, the histological diagnosis of GI a-GvHD was associated with an increased risk of steroid-resistant GvHD and with high transplant-related mortality.

CITATION EXPORT

Maura Faraci, Stefano Giardino, Annalisa Madeo et al.. Endoscopic Approach in the Diagnosis of Gastrointestinal Acute Graft Versus Host Disease in Children. JPGN reports. (2022). https://doi.org/10.1097/PG9.0000000000000163

AUTHORS

7 · 3 CENTRES

Maura Faraci, Stefano Giardino, Annalisa Madeo, Cristina Coccia, Serena Arrigo, Filomena Pierri, Paolo Gandullia

From the *Hematopoetic Stem Cell Transplant Unit, Hematology-Oncology Department, IRCSS-Istituto G. Gaslini, Genova, Italy
†Gastroenterology and Digestive Endoscopy Unit, IRCSS—Istituto G. Gaslini, Genova, Italy
‡Department of Pathology, IRCSS-Istituto G. Gaslini, Genova, Italy.