ArticleDigestive diseases and sciences2016
The Diagnostic Yield of Site and Symptom-Based Biopsies for Acute Gastrointestinal Graft-Versus-Host Disease: A 5-Year Retrospective Review.
Article in Digestive diseases and sciences, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 21 citations in OpenAlex.
- Post-stem cell transplantation pediatric gastrointestinal graft-versus-host disease: nomogram analysis of clinical and endoscopic features.Pediatric research · 2026Article
- Round-Robin test for the histological diagnosis of acute colonic Graft-versus-Host disease validating established histological criteria and grading systems.Virchows Archiv : an international journal of pathology · 2023Article
- What causes aplastic anaemia?Leukemia · 2023Review
- Being certain even when you're wrong: heuristics and thin slicing in haematopoietic cell transplantation.Bone marrow transplantation · 2021Article
- Diagnostic accuracy of maternal serum multiple marker screening for early detection of gestational diabetes mellitus in the absence of a gold standard test.BMC pregnancy and childbirth · 2020Article
- Application of latent class analysis in diagnosis of graft-versus-host disease by serum markers after allogeneic haematopoietic stem cell transplantation.Scientific reports · 2020Article
- Stress responses, M2 macrophages, and a distinct microbial signature in fatal intestinal acute graft-versus-host disease.JCI insight · 2019Article
- Review
- Use of the National Institutes of Health Consensus Guidelines Improves the Diagnostic Sensitivity of Gastrointestinal Graft-Versus-Host Disease.Archives of pathology & laboratory medicine · 2018Article
- Late Gastrointestinal Complications of Allogeneic Hematopoietic Stem Cell Transplantation in Adults.Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation · 2018Article
- Effective and less invasive diagnostic strategy for gastrointestinal GVHD.Endoscopy international open · 2018Article
- Article
- Acute graft-versus-host disease of the gut: considerations for the gastroenterologist.Nature reviews. Gastroenterology & hepatology · 2017Review
- Histologic Grade 1 Is Associated With Increased Nonrelapsed Mortality in Lower Gastrointestinal Graft Versus Host Disease.The American journal of surgical pathology · 2017Article
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Authors and funding
14 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundGraft-versus-host disease (GVHD) complicates half of hematopoietic stem cell transplants (HCT), and the gastrointestinal tract is commonly affected. Endoscopic biopsies have a key role in the diagnosis. The optimal procedure(s) to perform and site(s) to biopsy remain unclear.
methodsWe retrospectively analyzed the charts of all adult patients who underwent allogeneic HCT at Duke University Medical Center between 1/1/05 and 1/1/11 and extracted data from those who underwent endoscopic biopsy for suspected GVHD. All histology was re-evaluated by blinded pathologists using 2006 NIH diagnostic criteria and then compared to the original clinical diagnosis of GVHD.
resultsA total of 169 adult patients underwent 250 endoscopic procedures to evaluate GVHD. The sensitivity of biopsies for clinical GVHD was 76 and 72% for upper and lower tract sites, respectively. In the presence of nausea, upper tract biopsies were positive for GVHD in 65%, 70% while lower tract biopsies were positive in 61-70%. In the presence of diarrhea, lower tract biopsies were positive in 65%, while upper tract sites were positive in 64-69%. Twenty six (40%) of the sixty-five endoscopies that simultaneously sampled upper and lower tract sites had discordant results. All were histologically positive for GVHD, yet 15% of upper tract biopsies and 25% of lower tract biopsies were negative.
conclusionsIn this large review, the overall sensitivity of biopsies taken during EGD and Flex-Sig was 76 and 72%, respectively. A symptom-driven biopsy approach was not clearly supported as upper tract and lower tract biopsies were similarly diagnostic for GVHD regardless of symptoms.
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