Title | Diagnostic endoscopy in children after hematopoietic stem cell transplantation. |
Publication Type | Journal Article |
Year of Publication | 2006 |
Authors | Khan K, Schwarzenberg SJane, Sharp H, Jessurun J, H Gulbahce E, Defor T, Nagarajan R |
Journal | Gastrointest Endosc |
Volume | 64 |
Issue | 3 |
Pagination | 379-85; quiz 389-92 |
Date Published | 2006 Sep |
ISSN | 0016-5107 |
Keywords | Adolescent, Adult, Child, Child, Preschool, Endoscopy, Gastrointestinal, Female, Gastrointestinal Diseases, Graft vs Host Disease, Hematopoietic Stem Cell Transplantation, Humans, Infant, Male, Retrospective Studies |
Abstract | OBJECTIVE: To determine the diagnostic yield versus complications from endoscopy in children after hematopoietic stem cell transplantation (HSCT). DESIGN: Data from 191 patients were reviewed, then separated into procedures within the first 100 days after HSCT (when the risks for complications and prevalence of acute graft-versus-host disease [GVHD] are highest) and those performed beyond 100 days. RESULTS: Visible endoscopic lesions were found in 63 of 198 (32%) esophagogastroduodenoscopies (EGDs) and 36 of 220 (16%) sigmoidoscopies. Acute GVHD was present in 38 of 121 (31%) biopsy specimens from EGDs within the first 100 days, 15 of 73 (21%) samples from EGDs after 100 days, 52 of 136 (38%) sigmoid biopsy specimens before 100 days, and in 25 of 82 (31%) samples after 100 days. Non-GVHD histologic abnormalities were present in 36 of 124 (29%) biopsy samples from EGDs before 100 days, 32 of 74 (43%) specimens after 100 days, 14 of 136 (10%) sigmoid specimens before 100 days, and 11 of 84 (13%) samples beyond 100 days. COMPLICATIONS: Complications occurred in 13 procedures (3.1%): 8 (4.2%) EGDs, 4 (2.0%) sigmoidoscopies, and 1 (5.5%) colonoscopy. Intestinal bleeding occurred in 12 of the 13 procedures. Thrombocytopenia was a statistically significant association (p < 0.01). One death occurred after splenic flexure perforation. CONCLUSIONS: GI abnormalities other than acute GVHD occurred in children after HSCT. Acute GVHD was diagnosed most commonly on sigmoid biopsy. Postprocedure hemorrhage was related to thrombocytopenia. |
DOI | 10.1016/j.gie.2005.08.040 |
Alternate Journal | Gastrointest Endosc |
PubMed ID | 16923486 |
Related Faculty:
Jose Jessurun, M.D.