Intestinal Graft-Versus-Host Disease after Bone Marrow Transplantation: 7 Cases Proven by Histopathologic Diagnosis / 대한소화기내시경학회지

ABSTRACT

Graft-versus-host disease (GVHD) is the major cause of morbidity or mortality after marrow transplantation. The intestinal involvement of GVHD is associated with high graft failure. It is usually difficult to diagnose gastrointestinal (GI) GVHD because symptom is nonspecific, and diagnostic criteria in endoscopic and histologic findings lack the gold standard. We reviewed 7 patients with GI GVHD proven by endoscopic biopsy from September 1999 to June 2003. The common GI symptoms at the time of endoscopy were diarrhea and abdominal pain. Four patients were acute GVHD, two acute and chronic GVHD, and one chronic GVHD. The interval from bone marrow transplantation to GVHD diagnosis by histological examination varied from 18 days to 259 days. The skin was involved in 5 patients. Two cases showed normal endoscopic finding. From these results, endoscopic biopsy is a essential tool in evaluating patients with GI complaints after bone marrow transplantation.