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Query: UMLS:C0018133 (
graft-versus-host disease
)
18,032
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Computed tomography (CT) is valuable for detection and characterization of many inflammatory conditions of the colon. At CT, a dilated, thickened appendix is suggestive of appendicitis. A 1-4-cm, oval, fatty pericolic lesion with surrounding mesenteric inflammation is diagnostic of epiploic appendagitis. The key to distinguishing diverticulitis from other inflammatory conditions of the colon is the presence of diverticula in the involved segment. In typhlitis, CT demonstrates cecal distention and circumferential thickening of the cecal wall, which may have low attenuation secondary to edema. In radiation
colitis
, the clinical history is the key to suggesting the diagnosis because the CT findings can be nonspecific. The location of the involved segment and the extent and appearance of wall thickening may help distinguish Crohn disease and ulcerative colitis. In ischemic colitis, CT typically demonstrates circumferential, symmetric wall thickening with fold enlargement. CT findings of
graft-versus-host disease
include small bowel and colonic wall thickening, which may result in luminal narrowing and separation of bowel loops. In infectious colitis, the site and thickness of colon affected may suggest a specific organism. The amount of wall thickening in pseudomembranous colitis is typically greater than in any other inflammatory disease of the colon except Crohn disease.
...
PMID:CT evaluation of the colon: inflammatory disease. 1071 39
Histological reaction patterns within the colon are not disease-specific but reflect mechanisms of injury and duration of disease. By correlating these patterns with known causes of colonic inflammation, we provide guidelines to enhance the diagnostic value of colonoscopic samples. Normal histological features are reviewed, and the sequence of inflammation and repair is used as the basis for appreciating pathological deviations. The common histological patterns of acute
colitis
with and without features of pseudomembranous or ischemic colitis and the morphological features of chronic
colitis
with and without crypt destruction are collated with clinical and endoscopic features to emphasize the importance of dialogue between the pathologist and gastroenterologist. Less common patterns, including eosinophilic
colitis
,
graft-versus-host disease
, chronic mucosal prolapse, portal hypertensive colopathy, and nonspecific or idiopathic ulcer, illustrate variations in the basic reaction patterns. Difficulties in differential diagnosis are underscored, and biopsy strategies are suggested.
...
PMID:The importance of clinicopathological correlation in the diagnosis of inflammatory conditions of the colon: histological patterns with clinical implications. 1076 32
We describe the clinical activity of the ABL kinase inhibitor STI571 in a patient with accelerated phase of chronic myeloid leukemia (CML) relapsing after a second allogeneic BMT and with minimal levels of donor chimerism. STI571 resulted in rapid elimination of leukemic cells with ensuing prolonged severe leukopenia and neutropenia complicated by neutropenic fever and
colitis
. Subsequent hematopoietic recovery was driven by donor derived cells and was associated with grade 3
graft-versus-host disease
(
GVHD
). STI571 induced sustained hematological and cytogenetic remission combined with controllable GvHD, therapeutic goals not achieved by two preceding allogeneic transplants and repeated donor lymphocyte transfusions (DLT).
...
PMID:Hematologic and cytogenetic remission by STI571 (Glivec) in a patient relapsing with accelerated phase CML after second allogeneic stem cell transplantation. 1170 99
We present the case of a patient with a malignant thymoma associated with a
graft-versus-host disease
-type
colitis
, of which there has only been a solitary case report in the world literature. Complete surgical resection of the thymoma was achieved; however, the gastrointestinal symptoms persisted.
...
PMID:Graft-versus-host disease-type colitis: an unusual association of malignant thymoma. 1207 95
The common pathway of any apoptotic cascade leads to the activation of the so-called execution caspases, particularly caspase-3 (CSP3). The question of whether immunohistochemical (IHC) detection of activated CSP3 might be useful for routine purposes still needs to be clarified. We analyzed apoptoses in gastrointestinal
graft-versus-host disease
(GvHD) and cytomegalovirus (CMV)
colitis
using a commercially available polyclonal antibody against activated human CSP3. In GvHD samples obtained from the colon, apoptoses detected by CSP3 varied between 11 and 43/40 crypts, and in esophageal specimens between 21 and 40/1.5 mm squamous epithelium basal length. This count was correlated with the apoptotic count assessed on hematoxylin- and eosin (H&E)-stained slides. A perfect concordance for those counting between 30 and 40 apoptoses/40 crypts or 1.5 mm squamous epithelium basal length was detected, whereas cases with low apoptotic counts on the H&E stained slides showed a 2 to 3 fold greater number of stained nuclei as assessed by CSP3 staining. In CMV-
colitis
, although the number of exploding crypt cells was 8-13/40 crypts, only 1-2 nuclei/40 crypts and almost all cells with typical nuclear inclusions stained positively. The presence of CMV can be easily detected on H&E- or IHC-stained slides, while masked GvHD by an overlying CMV-
colitis
might remain unrecognized. Staining for CSP3 may be helpful in distinguishing these two conditions, as apoptotic count would be excessive in GvHD.
...
PMID:Detection of apoptoses in gastro-intestinal graft-versus-host disease and cytomegalovirus colitis by a commercially available antibody against caspase-3. 1290 24
Mycophenolate mofetil (MMF) is widely used for maintenance immunosuppression in solid organ transplantation. Gastrointestinal toxicity, usually manifested as diarrhea, is the most common side effect of MMF. We evaluated colonic biopsies from 20 renal transplant patients with MMF-related diarrhea. The latter was defined by the absence of any other demonstrable etiology and improvement or resolution of symptoms by the discontinuation or reduction of the dose of MMF alone. These biopsies were compared with colon biopsies from patients with the following: acute
graft-versus-host disease
(
GVHD
, n=10), inflammatory bowel disease (IBD) or infectious colitis (n=10), and colon biopsies from renal transplant patients not receiving MMF (n=8). Normal colonic segments from surgical specimens served as normal controls (n=5). Colonic biopsies from patients with MMF-related diarrhea showed prominent crypt cell apoptosis and reactive/reparative changes including enterocyte cytologic atypia, increased neuroendocrine cells, and glandular architectural distortion. The changes were similar, although of milder degree to the ones seen in patients with acute intestinal
GVHD
. This pattern of injury was not seen in controls or in biopsies from transplant patients not receiving MMF, and it was markedly different from the one seen in idiopathic inflammatory or infectious colitis. The severity of histologic changes correlated significantly with the endoscopic degree of "colitis." There was no statistically significant correlation between histologic damage and the dose of MMF (corrected for body weight and renal function). MMF-related
colitis
is a distinct entity that displays histologic features remarkably similar to the ones associated with intestinal
GVHD
. This form of injury could be related to either direct toxicity or an "innocent by-stander" phenomenon secondary to the alteration of the immunologic microenvironment of the colon caused by the MMF.
...
PMID:Histologic features of mycophenolate mofetil-related colitis: a graft-versus-host disease-like pattern. 1461 24
Graft-versus-host disease
(GVHD)
colitis
after allogeneic bone marrow transplantation or peripheral blood stem cell transplantation was often accompanied with upper gastro-intestinal symptoms such as upper abdominal pain. We investigated 7 cases of gastro-duodenal lesions with GVHD
colitis
. Endoscopic features of gastric lesions with GVHD were turbidity(100%), erythema(100%), erosions(85.7%), easy bleeding of mucosa(71.4%) and duodenal involvement(71.4%), histological findings of those were infiltration of inflammatory cells(100%), dilatation of capillaries(100%), hemorrhage(71.4%), stromal edema(85.7%), degenerated glands and apoptotic bodies(100%). Those findings resembled with endoscopic and histological features of GVHD
colitis
, so we diagnosed those lesions as GVHD gastro-duodenitis. Clinically GVHD
colitis
with gastro-duodenitis was severe compared with
colitis
without gastro-duodenitis.
...
PMID:[GVHD gastro-duodenitis]. 1503
The alpha1beta1 integrin, also known as "very late antigen" (VLA)-1, is normally expressed on mesenchymal cells, some epithelial cells, activated T cells, and macrophages, and interacts, via the I-domain of the extracellular domain of the alpha1 subunit, with collagen molecules in the extracellular matrix (ECM). By "outside-in" transmembranal signaling to the interior of the cell, it mediates adhesion, migration, proliferation, remodeling of the ECM, and cytokine secretion by endothelial cells, mesangial cells, fibroblasts, and immunocytes. Importantly, its expressions and functions are enhanced by inflammatory cytokines including interferon (IFN)gamma and tumor necrosis factor (TNF)alpha, thus augmenting angiogenesis and fibrosis linked, in particular, to inflammation. Moreover, within the immune system, VLA-1 marks effector memory CD4+ and CD8+ T cells that are retained in extralymphatic tissues by interactions of the integrin with collagen and produce high levels of IFNgamma. Thus, immune-mediated inflammation in vivo is inhibited by blockade of the VLA-1-collagen interaction in experimental animal models of arthritis,
colitis
, nephritis, and
graft versus host disease
(
GVHD
), suggesting that inhibiting the interaction of the alpha1 I-domain with its ligands or modulating "outside-in" signaling by VLA-1 would be a useful approach in the human diseases simulated by these experimental models.
...
PMID:The role of very late antigen-1 in immune-mediated inflammation. 1545 66
We studied 228 consecutive stem cell transplant recipients, screened for reactivation of human herpesvirus-6 (HHV-6) in peripheral blood and other specimens as clinically indicated by means of qualitative polymerase chain reaction. Among them, 197 received an allograft and 31 autograft. Ninety-six of 228 patients (42.1%) showed HHV-6 reactivation in peripheral blood and 129 of 228 (56.6%) demonstrated HHV-6 in at least one of the specimens tested. 41.9% of patients were asymptomatic when HHV-6 was identified. Clinical features, noted when HHV-6 was detected, included interstitial or alveolar pneumonia, gastroduodenal and colorectal disease, bone marrow suppression and liver disease. However, based on clinical and histopathological criteria, HHV-6 was considered a causal agent in only a minority of patients, in particular, those suffering from bone marrow suppression (n = 11), gastroduodenitis (five),
colitis
(three), interstitial/alveolar pneumonia (five), skin rash (one), pericarditis (two) and encephalitis (one). HHV-6 reactivation was significantly associated with the occurrence of
graft-versus-host disease
[odds ratio (OR) 5.31], Epstein-Barr virus coinfection (OR 8.89) and unrelated donor transplantation (OR 5.67) indicating an increased stage of immunosuppression.
...
PMID:Impact of human herpesvirus-6 after haematopoietic stem cell transplantation. 1560 51
Hematopoietic stem cell transplantation is used to treat hematologic disorders and as an adjunct treatment for solid organ malignancies. After undergoing transplantation, patients are at risk for opportunistic infections and other complications caused by dysfunction of the immune system. Pulmonary complications include cryptogenic organizing pneumonia, opportunistic pneumonias caused by Aspergillus and Zygomycetes species and cytomegalovirus, alveolar hemorrhage, and constrictive bronchiolitis. Abdominal complications include hepatic veno-occlusive disease,
graft-versus-host disease
(
GVHD
),
colitis
, and hemorrhagic cystitis. Allogeneic transplant recipients are at risk for developing
GVHD
. Autologous and syngeneic transplant recipients are less likely to have chronic or late posttransplantation complications. Nonmyeloablative transplant recipients are less likely to develop opportunistic infections and other complications in the period immediately following transplantation, but are at risk for developing chronic
GVHD
and other chronic complications. Radiologic evaluation serves as the cornerstone for timely diagnosis of these complications, which is essential to reduce patient morbidity and mortality. Combining clinical factors-including the type of transplant and the point of time during the posttransplantation course-with characteristic imaging features yields the most specific and accurate differential diagnosis for radiologic findings in stem cell transplant recipients.
...
PMID:Imaging evaluation of pulmonary and abdominal complications following hematopoietic stem cell transplantation. 1579 50
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