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Association between histopathological alterations and diarrhea severity in acute intestinal graft-versus-host disease
Gastrointestinal (GI) acute graft-versus-host disease (aGVHD) remains one of the most important complications of allogeneic hematopoietic cell transplantation (allo-HCT). The diagnosis of this complication is largely dependent on clinical symptoms, but GI biopsies are warranted in most cases, due to...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5959433/ https://www.ncbi.nlm.nih.gov/pubmed/29742694 http://dx.doi.org/10.1097/MD.0000000000010600 |
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author | da Costa, Loredana Nilkenes Gomes Costa-Lima, Carolina de Meirelles, Luciana Rodrigues Carvalho, Rita B. Colella, Marcos Paulo Aranha, Francisco Jose Penteado Vigorito, Afonso Celso De Paula, Erich Vinicius |
author_facet | da Costa, Loredana Nilkenes Gomes Costa-Lima, Carolina de Meirelles, Luciana Rodrigues Carvalho, Rita B. Colella, Marcos Paulo Aranha, Francisco Jose Penteado Vigorito, Afonso Celso De Paula, Erich Vinicius |
author_sort | da Costa, Loredana Nilkenes Gomes |
collection | PubMed |
description | Gastrointestinal (GI) acute graft-versus-host disease (aGVHD) remains one of the most important complications of allogeneic hematopoietic cell transplantation (allo-HCT). The diagnosis of this complication is largely dependent on clinical symptoms, but GI biopsies are warranted in most cases, due to the multitude of potential causes that coexist in patients with a clinical suspicion of this complication. In addition, several lines of evidence support that the GI is not only a target organ in aGVHD, but also a key mediator of the pathogenesis of this condition. Controversy exists on whether histopathological findings are associated with clinical severity. Crypt loss is a relatively straightforward histological finding of GI aGVHD, whose presence has been associated with disease severity in a previous study. In order to independently validate this association, we retrospectively evaluated all histological changes from 25 patients with confirmed GI aGVHD who underwent allo-HCT in our center from 2008 to 2014. Clinical, laboratory, and histological data were obtained from the medical records and pathological reports. All GI biopsies were reviewed by 2 investigators blinded to clinical data, who classified GI aGVHD according to the presence of severe crypt loss. The proportion of patients with grades I–II and III–IV aGVHD patients in our population were 45.5% and 54.5%, respectively. The most common histological alterations were isolated apoptotic bodies, present in 80% of colon biopsies with aGVHD. Severe crypt loss, corresponding to grades III–IV aGVHD was associated with higher stool volumes (P = .02) and increased diarrhea duration (P = .02), but not with response to steroids or mortality. In this study, we independently validated that the presence of severe crypt loss, a reliable and simple parameter to grade the extension of GI aGVHD, is associated with disease severity in GI aGVHD. |
format | Online Article Text |
id | pubmed-5959433 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-59594332018-05-24 Association between histopathological alterations and diarrhea severity in acute intestinal graft-versus-host disease da Costa, Loredana Nilkenes Gomes Costa-Lima, Carolina de Meirelles, Luciana Rodrigues Carvalho, Rita B. Colella, Marcos Paulo Aranha, Francisco Jose Penteado Vigorito, Afonso Celso De Paula, Erich Vinicius Medicine (Baltimore) Research Article Gastrointestinal (GI) acute graft-versus-host disease (aGVHD) remains one of the most important complications of allogeneic hematopoietic cell transplantation (allo-HCT). The diagnosis of this complication is largely dependent on clinical symptoms, but GI biopsies are warranted in most cases, due to the multitude of potential causes that coexist in patients with a clinical suspicion of this complication. In addition, several lines of evidence support that the GI is not only a target organ in aGVHD, but also a key mediator of the pathogenesis of this condition. Controversy exists on whether histopathological findings are associated with clinical severity. Crypt loss is a relatively straightforward histological finding of GI aGVHD, whose presence has been associated with disease severity in a previous study. In order to independently validate this association, we retrospectively evaluated all histological changes from 25 patients with confirmed GI aGVHD who underwent allo-HCT in our center from 2008 to 2014. Clinical, laboratory, and histological data were obtained from the medical records and pathological reports. All GI biopsies were reviewed by 2 investigators blinded to clinical data, who classified GI aGVHD according to the presence of severe crypt loss. The proportion of patients with grades I–II and III–IV aGVHD patients in our population were 45.5% and 54.5%, respectively. The most common histological alterations were isolated apoptotic bodies, present in 80% of colon biopsies with aGVHD. Severe crypt loss, corresponding to grades III–IV aGVHD was associated with higher stool volumes (P = .02) and increased diarrhea duration (P = .02), but not with response to steroids or mortality. In this study, we independently validated that the presence of severe crypt loss, a reliable and simple parameter to grade the extension of GI aGVHD, is associated with disease severity in GI aGVHD. Wolters Kluwer Health 2018-05-11 /pmc/articles/PMC5959433/ /pubmed/29742694 http://dx.doi.org/10.1097/MD.0000000000010600 Text en Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0 |
spellingShingle | Research Article da Costa, Loredana Nilkenes Gomes Costa-Lima, Carolina de Meirelles, Luciana Rodrigues Carvalho, Rita B. Colella, Marcos Paulo Aranha, Francisco Jose Penteado Vigorito, Afonso Celso De Paula, Erich Vinicius Association between histopathological alterations and diarrhea severity in acute intestinal graft-versus-host disease |
title | Association between histopathological alterations and diarrhea severity in acute intestinal graft-versus-host disease |
title_full | Association between histopathological alterations and diarrhea severity in acute intestinal graft-versus-host disease |
title_fullStr | Association between histopathological alterations and diarrhea severity in acute intestinal graft-versus-host disease |
title_full_unstemmed | Association between histopathological alterations and diarrhea severity in acute intestinal graft-versus-host disease |
title_short | Association between histopathological alterations and diarrhea severity in acute intestinal graft-versus-host disease |
title_sort | association between histopathological alterations and diarrhea severity in acute intestinal graft-versus-host disease |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5959433/ https://www.ncbi.nlm.nih.gov/pubmed/29742694 http://dx.doi.org/10.1097/MD.0000000000010600 |
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