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Clinical relevance ...
Clinical relevance of endoscopy with histopathological assessment in children with suspected gastrointestinal graft-versus-host disease
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- Martensson, T. (författare)
- Karolinska Institutet
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- Mellgren, Karin, 1962 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för pediatrik,Institute of Clinical Sciences, Department of Pediatrics,Univ Gothenburg, Sahlgrenska Acad, Inst Clin Sci, Dept Pediat, Gothenburg, Sweden.
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- Toporski, J. (författare)
- Skane Univ Hosp, Dept Pediat, Lund, Sweden.
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- Arvidson, Johan, 1953- (författare)
- Uppsala universitet,Barnneurologi/Barnonkologi
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- Szakos, A. (författare)
- Karolinska Univ Hosp, Dept Clin Pathol & Cytol, Stockholm, Sweden.
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- Casswall, T. H. (författare)
- Karolinska Institutet
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- Gustafsson, B. (författare)
- Karolinska Institutet
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(creator_code:org_t)
- 2020-04-30
- 2020
- Engelska.
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Ingår i: Clinical Transplantation. - : Wiley. - 0902-0063 .- 1399-0012. ; 34:7
- Relaterad länk:
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https://doi.org/10.1...
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Endoscopy with histopathological assessment is an established practice to confirm gastrointestinal graft-versus-host disease (GI-GVHD). However, the clinical relevance of this approach in children is incompletely evaluated. In a retrospective cohort study, we investigated the frequency of treatment changes in response to histopathological findings in all children (<18 years) in Sweden who underwent endoscopy for suspected GI-GVHD (2000-2013) after receiving hematopoietic stem cell transplantation. Sixty-eight children with ninety-one endoscopic occasions were enrolled. At the time of endoscopy, anti-GI-GVHD treatment was ongoing in 71% (65/91). In 18% (12/65) with ongoing treatment, no histopathological evidence of GI-GVHD or another cause to justify anti-GI-GVHD treatment was found. In 48% (44/91), endoscopy with histopathological assessment led to changes in the treatment regimen. Re-endoscopy was more frequent among those with treatment changes, versus unchanged treatment, 39% (17/44) and 13% (6/47), respectively (P = .007). Histopathological findings generating treatment changes were as follows: GI-GVHD in 68% (30/44), normal histology in 25% (11/44), and an alternative diagnosis in 7% (3/44). In conclusion, this study supports that endoscopy with histopathological assessment should be considered in all children with suspected GI-GVHD.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Gastroenterologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)
Nyckelord
- children
- endoscopy
- gastrointestinal graft-versus-host disease
- hematopoietic stem cell transplantation
- histopathology
- treatment
- change
- acute gvhd
- diagnosis
- association
- management
- criteria
- Surgery
- Transplantation
- children
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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