Graft-versus-host Disease (GVHD) of the Gut Youichiro Tokumitsu 1 , Takashi Matsuura 2 , Mitsuru Seo 1 , Takashi Yao 3 1Department of Internal Medicine, Hamanomachi General Hospital 2Department of Radiology, Hamanomachi General Hospital 3Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University Keyword: graft-versus-host disease , GVHD , 上部消化管急性GVHD , 急性GVHD腸炎 pp.601-610
Published Date 2003/4/24
DOI https://doi.org/10.11477/mf.1403100920
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 Acute GVHD after allogenic bone marrow transplantation involves the skin, liver, and GI tract. The histological findings in the GI tract are lymphocyte invasion into the mucosal epithelium, apoptosis of the glandular epithelium, and decrease in the number of glands. Acute upper GI tract GVHD symptoms are appetite loss, nausea, vomiting and hematemesis. Endoscopic findings are redness, erosions, edema, sloughing of the mucosa and, in acute gastric GVHD, diffuse bleeding. In acute duodenal GVHD, the findings are redness, erosions, edema, loss of Kerckring's fold, granular mucosa, sloughing of the mucosa, and diffuse bleeding. Early or mild acute GVHD in the upper GI tract presents non-specific findings such as superficial gastritis, erosive gastritis and duodenitis. Acute GVHD colitis symptoms are watery diarrhea and abdominal pain. Endoscopic findings of acute GVHD colitis are indistinct vascular pattern, white mucosa, erosions, edema, sloughing of the mucosa and ulcers. The specific endoscopic finding of severe acute GVHD in the GI tract is diffuse sloughing of the mucosa, which is never seen in other diseases.

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