Graft-versus-host disease other diagnostic studies: Difference between revisions

Jump to navigation Jump to search
No edit summary
m (Bot: Removing from Primary care)
 
(7 intermediate revisions by one other user not shown)
Line 4: Line 4:


==Overview==
==Overview==
 
Biopsies of the suspected organs can be used to help diagnose GvHD. A tissue diagnosis is not necessary, but helps a clinician make the diagnosis in the correct clinical context. The skin, liver, or GI tract can be readily biopsied.


==Other Diagnostic Studies==
==Other Diagnostic Studies==
The diagnosis of GvhD can be made at the histologic level via tissue biopsy. Biopsies of the suspected organs involved can aid in the diagnosis. A skin biopsy, for example, will show findings such as vacuolar interface dermatitis. The sensitivities of tissue biopsy is somewhat limited though, and nearly 40% of cases can be missed.<ref name="pmid23802653">{{cite journal| author=Qian L, Wu Z, Shen J| title=Advances in the treatment of acute graft-versus-host disease. | journal=J Cell Mol Med | year= 2013 | volume= 17 | issue= 8 | pages= 966-75 | pmid=23802653 | doi=10.1111/jcmm.12093 | pmc=3780546 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23802653  }} </ref> Biopsies of the upper GI tract can be achieved via endoscopy, and biopsies of the lower GI tract can be achieved via colonoscopy or flexible sigmoidoscopy.
The diagnosis of GvHD can be made at the histologic level via tissue biopsy. Biopsies of the suspected organs involved can aid in the diagnosis. The sensitivities of tissue biopsy is somewhat limited though, and nearly 40% of cases can be missed.<ref name="pmid23802653">{{cite journal| author=Qian L, Wu Z, Shen J| title=Advances in the treatment of acute graft-versus-host disease. | journal=J Cell Mol Med | year= 2013 | volume= 17 | issue= 8 | pages= 966-75 | pmid=23802653 | doi=10.1111/jcmm.12093 | pmc=3780546 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23802653  }} </ref>
*'''Skin''': A skin biopsy will show findings such as [[vacuolar interface dermatitis]]. Skin biopsy is typically done via a [[punch biopsy]] at bedside, without the requirement of local or general anesthesia. This is the most readily obtainable biopsy as it is the least invasive. 
*'''Liver''': A liver biopsy can be obtained via [[transjugular]] or [[percutananeous]] approaches. This is a relatively invasive procedure that requires anesthesia and carries a risk for bleeding and bowel perforation.
*'''GI tract''': A GI tract biopsy can be done via [[endoscopy]] (for upper GI tract) or [[colonoscopy]] or [[flexible sigmoidoscopy]] (for lower GI tract). These are moderately invasive procedures that requires sedation and carries a moderate risk for bleeding. GI tract biopsies are particular important if there is a clinical concern about CMV enteritis or CMV colitis, as it can be quite challenging to differentiate CMV infection from GI GvHD.


==References==
==References==
Line 15: Line 18:
{{WH}}
{{WH}}


[[Category:Primary care]]
[[Category:Hematology]]
[[Category:Hematology]]
[[Category:Immunology]]
[[Category:Immunology]]

Latest revision as of 21:56, 29 July 2020

Graft-versus-host disease

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Graft-versus-host disease from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

Echocardiograph and Ultrasound

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Graft-versus-host disease other diagnostic studies On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Graft-versus-host disease other diagnostic studies

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Graft-versus-host disease other diagnostic studies

CDC on Graft-versus-host disease other diagnostic studies

Graft-versus-host disease other diagnostic studies in the news

Blogs on Graft-versus-host disease other diagnostic studies

Directions to Hospitals Treating Type page name here

Risk calculators and risk factors for Graft-versus-host disease other diagnostic studies

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Shyam Patel [2]

Overview

Biopsies of the suspected organs can be used to help diagnose GvHD. A tissue diagnosis is not necessary, but helps a clinician make the diagnosis in the correct clinical context. The skin, liver, or GI tract can be readily biopsied.

Other Diagnostic Studies

The diagnosis of GvHD can be made at the histologic level via tissue biopsy. Biopsies of the suspected organs involved can aid in the diagnosis. The sensitivities of tissue biopsy is somewhat limited though, and nearly 40% of cases can be missed.[1]

  • Skin: A skin biopsy will show findings such as vacuolar interface dermatitis. Skin biopsy is typically done via a punch biopsy at bedside, without the requirement of local or general anesthesia. This is the most readily obtainable biopsy as it is the least invasive.
  • Liver: A liver biopsy can be obtained via transjugular or percutananeous approaches. This is a relatively invasive procedure that requires anesthesia and carries a risk for bleeding and bowel perforation.
  • GI tract: A GI tract biopsy can be done via endoscopy (for upper GI tract) or colonoscopy or flexible sigmoidoscopy (for lower GI tract). These are moderately invasive procedures that requires sedation and carries a moderate risk for bleeding. GI tract biopsies are particular important if there is a clinical concern about CMV enteritis or CMV colitis, as it can be quite challenging to differentiate CMV infection from GI GvHD.

References

  1. Qian L, Wu Z, Shen J (2013). "Advances in the treatment of acute graft-versus-host disease". J Cell Mol Med. 17 (8): 966–75. doi:10.1111/jcmm.12093. PMC 3780546. PMID 23802653.

Template:WS Template:WH