Non-Invasive Diagnosis of Pediatric Intestinal Graft-Versus-Host Disease: A Case Series
Intestinal graft-versus-host disease (I-GvHD) represents a life-threatening complication in allogeneic stem cell transplantation (SCT). Unfortunately, non-invasive validated diagnostic tools to diagnose I-GvHD, evaluate treatment response, and guide the duration of immunosuppression are still lackin...
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-03-01
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| Series: | Transplantology |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2673-3943/3/2/12 |
| _version_ | 1797481783001874432 |
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| author | Manuela Spadea Francesco Saglio Anna Opramolla Caterina Rigazio Fabio Cisarò Massimo Berger Paola Quarello Pier Luigi Calvo Franca Fagioli |
| author_facet | Manuela Spadea Francesco Saglio Anna Opramolla Caterina Rigazio Fabio Cisarò Massimo Berger Paola Quarello Pier Luigi Calvo Franca Fagioli |
| author_sort | Manuela Spadea |
| collection | DOAJ |
| description | Intestinal graft-versus-host disease (I-GvHD) represents a life-threatening complication in allogeneic stem cell transplantation (SCT). Unfortunately, non-invasive validated diagnostic tools to diagnose I-GvHD, evaluate treatment response, and guide the duration of immunosuppression are still lacking. We employed standard ultrasound and power Doppler to diagnose and follow up on pediatric intestinal GvHD. We herein report on three patients, prospectively evaluated among 24 pediatric patients referred to our center for allogeneic SCT. These three patients presented abdominal pain and diarrhea within the first 200 days after transplantation. In the reported cases, we performed small- and large-intestine ultrasound (US) at clinical onset of lower-intestinal symptoms and, when intestinal GvHD was confirmed, at GvHD flares, if any, and at follow-up. US constantly (3/3 patients) revealed increased bowel wall thickening (BWT) with different bowel segments’ involvement from patient to patient. Further, a moderate or strong increased Doppler signaling was seen in 2 out of 3 patients, according to clinical GVHD staging (e.g., the more the increase, the more the staging). Standard sonography corroborated GvHD diagnosis in all patients considered and was able to detect GvHD progression or complete normalization of findings, thus simplifying ensuing clinical decisions. Our report highlights the need to design clinical trials for the validation of non-invasive radiologic tools for diagnosis and follow-up of GvHD, especially in pediatric patients. |
| first_indexed | 2024-03-09T22:19:27Z |
| format | Article |
| id | doaj.art-ac1156f595f04179b58ba22cf8cde887 |
| institution | Directory Open Access Journal |
| issn | 2673-3943 |
| language | English |
| last_indexed | 2024-03-09T22:19:27Z |
| publishDate | 2022-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Transplantology |
| spelling | doaj.art-ac1156f595f04179b58ba22cf8cde8872023-11-23T19:17:39ZengMDPI AGTransplantology2673-39432022-03-013211512310.3390/transplantology3020012Non-Invasive Diagnosis of Pediatric Intestinal Graft-Versus-Host Disease: A Case SeriesManuela Spadea0Francesco Saglio1Anna Opramolla2Caterina Rigazio3Fabio Cisarò4Massimo Berger5Paola Quarello6Pier Luigi Calvo7Franca Fagioli8Pediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, A.O.U. Città della Salute e della Scienza-Regina Margherita Children’s Hospital, 10126 Turin, ItalyPediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, A.O.U. Città della Salute e della Scienza-Regina Margherita Children’s Hospital, 10126 Turin, ItalyUnit of Pediatric Gastroenterology and Hepatology, University Hospital City of Science and Health of Turin, Regina Margherita Children’s Hospital, Piazza Polonia 94, 10126 Turin, ItalyUnit of Pediatric Gastroenterology and Hepatology, University Hospital City of Science and Health of Turin, Regina Margherita Children’s Hospital, Piazza Polonia 94, 10126 Turin, ItalyUnit of Pediatric Gastroenterology and Hepatology, University Hospital City of Science and Health of Turin, Regina Margherita Children’s Hospital, Piazza Polonia 94, 10126 Turin, ItalyPediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, A.O.U. Città della Salute e della Scienza-Regina Margherita Children’s Hospital, 10126 Turin, ItalyPediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, A.O.U. Città della Salute e della Scienza-Regina Margherita Children’s Hospital, 10126 Turin, ItalyUnit of Pediatric Gastroenterology and Hepatology, University Hospital City of Science and Health of Turin, Regina Margherita Children’s Hospital, Piazza Polonia 94, 10126 Turin, ItalyPediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, A.O.U. Città della Salute e della Scienza-Regina Margherita Children’s Hospital, 10126 Turin, ItalyIntestinal graft-versus-host disease (I-GvHD) represents a life-threatening complication in allogeneic stem cell transplantation (SCT). Unfortunately, non-invasive validated diagnostic tools to diagnose I-GvHD, evaluate treatment response, and guide the duration of immunosuppression are still lacking. We employed standard ultrasound and power Doppler to diagnose and follow up on pediatric intestinal GvHD. We herein report on three patients, prospectively evaluated among 24 pediatric patients referred to our center for allogeneic SCT. These three patients presented abdominal pain and diarrhea within the first 200 days after transplantation. In the reported cases, we performed small- and large-intestine ultrasound (US) at clinical onset of lower-intestinal symptoms and, when intestinal GvHD was confirmed, at GvHD flares, if any, and at follow-up. US constantly (3/3 patients) revealed increased bowel wall thickening (BWT) with different bowel segments’ involvement from patient to patient. Further, a moderate or strong increased Doppler signaling was seen in 2 out of 3 patients, according to clinical GVHD staging (e.g., the more the increase, the more the staging). Standard sonography corroborated GvHD diagnosis in all patients considered and was able to detect GvHD progression or complete normalization of findings, thus simplifying ensuing clinical decisions. Our report highlights the need to design clinical trials for the validation of non-invasive radiologic tools for diagnosis and follow-up of GvHD, especially in pediatric patients.https://www.mdpi.com/2673-3943/3/2/12pediatric intestinal GvHDnon-invasive GvHD diagnosisultrasound and power Doppler |
| spellingShingle | Manuela Spadea Francesco Saglio Anna Opramolla Caterina Rigazio Fabio Cisarò Massimo Berger Paola Quarello Pier Luigi Calvo Franca Fagioli Non-Invasive Diagnosis of Pediatric Intestinal Graft-Versus-Host Disease: A Case Series Transplantology pediatric intestinal GvHD non-invasive GvHD diagnosis ultrasound and power Doppler |
| title | Non-Invasive Diagnosis of Pediatric Intestinal Graft-Versus-Host Disease: A Case Series |
| title_full | Non-Invasive Diagnosis of Pediatric Intestinal Graft-Versus-Host Disease: A Case Series |
| title_fullStr | Non-Invasive Diagnosis of Pediatric Intestinal Graft-Versus-Host Disease: A Case Series |
| title_full_unstemmed | Non-Invasive Diagnosis of Pediatric Intestinal Graft-Versus-Host Disease: A Case Series |
| title_short | Non-Invasive Diagnosis of Pediatric Intestinal Graft-Versus-Host Disease: A Case Series |
| title_sort | non invasive diagnosis of pediatric intestinal graft versus host disease a case series |
| topic | pediatric intestinal GvHD non-invasive GvHD diagnosis ultrasound and power Doppler |
| url | https://www.mdpi.com/2673-3943/3/2/12 |
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