| Title |
The Diagnostic Yield of Site and Symptom-Based Biopsies for Acute Gastrointestinal Graft-Versus-Host Disease: A 5-Year Retrospective Review
|
|---|---|
| Published in |
Digestive Diseases and Sciences, November 2015
|
| DOI | 10.1007/s10620-015-3938-8 |
| Pubmed ID | |
| Authors |
Daniel Wild, Anthony D. Sung, Diana Cardona, Constance Cirricione, Keith Sullivan, Claire Detweiler, Michael Shealy, Bryan Balmadrid, Krista L. Rowes, Nelson Chao, Sadhna Piryani, Hossein Mehdikhani Karimabad, Paul Martin, Martin Poleski |
| Abstract |
Graft-versus-host disease (GVHD) complicates half of hematopoietic stem cell transplants (HCT), and the gastrointestinal tract is commonly affected. Endoscopic biopsies have a key role in the diagnosis. The optimal procedure(s) to perform and site(s) to biopsy remain unclear. We retrospectively analyzed the charts of all adult patients who underwent allogeneic HCT at Duke University Medical Center between 1/1/05 and 1/1/11 and extracted data from those who underwent endoscopic biopsy for suspected GVHD. All histology was re-evaluated by blinded pathologists using 2006 NIH diagnostic criteria and then compared to the original clinical diagnosis of GVHD. A total of 169 adult patients underwent 250 endoscopic procedures to evaluate GVHD. The sensitivity of biopsies for clinical GVHD was 76 and 72 % for upper and lower tract sites, respectively. In the presence of nausea, upper tract biopsies were positive for GVHD in 65 %, 70 % while lower tract biopsies were positive in 61-70 %. In the presence of diarrhea, lower tract biopsies were positive in 65 %, while upper tract sites were positive in 64-69 %. Twenty six (40 %) of the sixty-five endoscopies that simultaneously sampled upper and lower tract sites had discordant results. All were histologically positive for GVHD, yet 15 % of upper tract biopsies and 25 % of lower tract biopsies were negative. In this large review, the overall sensitivity of biopsies taken during EGD and Flex-Sig was 76 and 72 %, respectively. A symptom-driven biopsy approach was not clearly supported as upper tract and lower tract biopsies were similarly diagnostic for GVHD regardless of symptoms. |
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Canada | 1 | 5% |
| Unknown | 19 | 95% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 3 | 15% |
| Student > Master | 3 | 15% |
| Student > Bachelor | 2 | 10% |
| Student > Doctoral Student | 2 | 10% |
| Researcher | 2 | 10% |
| Other | 5 | 25% |
| Unknown | 3 | 15% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 7 | 35% |
| Nursing and Health Professions | 3 | 15% |
| Environmental Science | 1 | 5% |
| Business, Management and Accounting | 1 | 5% |
| Social Sciences | 1 | 5% |
| Other | 1 | 5% |
| Unknown | 6 | 30% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 24 March 2016.
All research outputs
#19,382,126
of 23,854,458 outputs
Outputs from Digestive Diseases and Sciences
#3,362
of 4,304 outputs
Outputs of similar age
#210,125
of 288,871 outputs
Outputs of similar age from Digestive Diseases and Sciences
#35
of 55 outputs
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