TY - JOUR
T1 - Impact of small bowel exploration using video-capsule endoscopy in the management of acute gastrointestinal graft-versus-host disease
AU - Yakoub-Agha, Ibrahim
AU - Maunoury, Vincent
AU - Wacrenier, Agnés
AU - Couignoux, Sandrine
AU - Depil, Stéphane
AU - Desreumaux, Pierre
AU - Bauters, Francis
AU - Colombel, Jean Frédéric
AU - Jouet, Jean Pierre
PY - 2004/12/15
Y1 - 2004/12/15
N2 - Background. The purpose of this study was to evaluate the impact of the global diagnostic approach on the outcome of patients suspected of having acute (a) gastrointestinal (GI) graft-versus-host disease (GVHD). Methods. Ten consecutive patients with suspected aGI-GVHD were prospectively explored with an exhaustive approach including video-capsule endoscopy (VCE). Images observed with VCE were compared with results obtained with other GI investigations including duodenal biopsies. Results. Five patients had a normal VCE examination: four were successfully treated symptomatically, but one died as a result of toxoplasmosis. VCE disclosed aGI-GVHD lesions in all five remaining patients, and two of the five were considered normal by upper GI endoscopy. All of these patients experienced improvement in their GI symptoms within 2 weeks of adjustments to their immunosuppressive treatment. Conclusions. This approach has enhanced the authors' ability to adapt immunosuppressive treatments in patients suffering from suspected aGI- GVHD. Further investigation of the apparently high negative predictive value of VCE will be of great interest, particularly with a view to avoiding unnecessary immunosuppressive treatment.
AB - Background. The purpose of this study was to evaluate the impact of the global diagnostic approach on the outcome of patients suspected of having acute (a) gastrointestinal (GI) graft-versus-host disease (GVHD). Methods. Ten consecutive patients with suspected aGI-GVHD were prospectively explored with an exhaustive approach including video-capsule endoscopy (VCE). Images observed with VCE were compared with results obtained with other GI investigations including duodenal biopsies. Results. Five patients had a normal VCE examination: four were successfully treated symptomatically, but one died as a result of toxoplasmosis. VCE disclosed aGI-GVHD lesions in all five remaining patients, and two of the five were considered normal by upper GI endoscopy. All of these patients experienced improvement in their GI symptoms within 2 weeks of adjustments to their immunosuppressive treatment. Conclusions. This approach has enhanced the authors' ability to adapt immunosuppressive treatments in patients suffering from suspected aGI- GVHD. Further investigation of the apparently high negative predictive value of VCE will be of great interest, particularly with a view to avoiding unnecessary immunosuppressive treatment.
KW - Acute gastrointestinal graft-versus-host disease
KW - Allogeneic stem-cell transplantation
KW - Video-capsule endoscopy
UR - http://www.scopus.com/inward/record.url?scp=10644249811&partnerID=8YFLogxK
U2 - 10.1097/01.TP.0000141092.08008.96
DO - 10.1097/01.TP.0000141092.08008.96
M3 - Article
C2 - 15591963
AN - SCOPUS:10644249811
SN - 0041-1337
VL - 78
SP - 1697
EP - 1701
JO - Transplantation
JF - Transplantation
IS - 11
ER -