ABSTRACT
Introducción: La enfermedad injerto contra huésped (EICH) esuna complicación frecuente de los trasplantes de células precursorashematopoyéticas alogénicos (alo-TCPH), con gran morbimortalidad.La clínica intestinal es inespecífica, planteando el diagnóstico diferencial con infecciones y etiología medicamentosa. Aunque las biopsiasintestinales son el gold standard, no existe consenso sobre la mejortécnica para obtenerlas.nObjetivo: Evaluar los resultados de las técnicas empleadas paraobtener biopsias en pacientes con sospecha de EICH intestinal. Material y métodos: Estudio retrospectivo que incluye pacientessometidos a alo-TCPH entre 2010 y 2019, con sospecha de EICH intes-tinal estudiados mediante biopsias digestivas: esofagogastroduodenales(endoscopia digestiva alta - EDA) o rectales (colonoscopia o biopsiadirecta). Recogimos variables cuantitativas, expresadas como medianay rango intercuartílico; y cualitativas, expresadas en frecuencia absolutay porcentaje. Resultados: Estudiamos 23 pacientes (60,9% varones). La medianade edad en el momento de la biopsia fue 9 años (7-14 años). EmpleamosEDA en el 47,8% (n= 11), colonoscopia en 26,1% (n= 6) y biopsiadirecta en el 34,8% (n= 8); siendo positivas para EICH en 2 (18,2%), 2(33,3%) y 4 (50%), respectivamente.Conclusiones. Las muestras obtenidas mediante biopsia directase plantean como una alternativa eficiente en el diagnóstico del EICH.(AU)
Introduction: Graft-versus-host disease (GVHD) is a frequentcomplication of allogeneic hematopoietic stem cell transplantation(allo-HSCT), with high morbidity and mortality rates. Intestinalclinical signs are unspecific, which means differential diagnosis withinfections and drug-related etiology should be carried out. Even though intestinal biopsy is widely considered as the gold standardtechnique, there is no consensus as to which sampling method is best. Objective: To assess the results of the biopsy techniques usedin patients with suspected intestinal GVHD.Materials and methods. A retrospective study of patients withsuspected intestinal GVHD undergoing allo-HSCT from 2010 to2019 was carried out. They were assessed through digestive biopsy esophagogastroduodenal biopsy (upper GI endoscopy UGIE)or rectal biopsy (colonoscopy or direct biopsy). Quantitative vari-ables, expressed as median and interquartile range, and qualitativevariables, expressed as absolute frequency and percentage, werecollected. Results:23 patients were studied, 60.9% of whom were male.Median age at biopsy was 9 years (7-14 years). UGIE was used in47.8% of patients (n=11), colonoscopy was used in 26.1% of pa-tients (n=6), and direct biopsy was used in 34.8% of patients (n=8),with GVHD positive results in 2 (18.2%), 2 (33.3%), and 4 (50%)patients, respectively. Conclusions: Samples taken through direct biopsy stand as aneffective alternative in GVHD diagnosis.(AU)
