Early detection of acute graft‐versus‐host disease by wireless capsule endoscopy and probe‐based confocal laser endomicroscopy: results of a pilot study. Issue 3 (1st June 2014)

• Record Type: Journal Article
• Authors: Coron, Emmanuel; Laurent, Valerie; Malard, Florent; Le Rhun, Marc; Chevallier, Patrice; Guillaume, Thierry; Mosnier, Jean-François; Galmiche, Jean-Paul; Mohty, Mohamad
• Is Part Of: United European Gastroenterology journal. Volume 2:Issue 3(2014:Jun.)
• Page Start: 206
• Page End: 215
• Publication Date: 2014-06-01
• Subjects: Early diagnosis -- graft-versus-host disease -- novel imaging techniques -- probe-based confocal laser endomicroscopy -- wireless capsule endoscopy; Gastroenterology -- Periodicals; Periodicals; 616.33005
• DOI: 10.1177/2050640614529283
• Languages: English
• ISSNs: 2050-6406

Abstract

Abstract : Objective: Acute gastrointestinal graft‐versus‐host disease (GI‐GVHD) is usually diagnosed using endoscopic examinations and biopsies for conventional histology. The aim of this pilot study was to determine whether mini‐invasive techniques such as probe‐based confocal laser endomicroscopy (pCLE) combined with wireless capsule endoscopy (WCE) could detect early lesions of GI‐GVHD prior to symptoms. Design: Fifteen patients undergoing allogeneic haematopoietic stem cell transplantation (allo‐HSCT) were prospectively examined with a small bowel WCE, duodenal and colorectal pCLE, and standard biopsies. Per study protocol, all these examinations were scheduled between day 21 and day 28 after allo‐HSCT, independently of the presence or absence of digestive symptoms. Results: During follow up, eight patients developed acute GI‐GVHD. Sensitivity of WCE, pCLE, and histology were 50, 87.5, and 50%, respectively. Specificity of WCE, pCLE, and histology were 80, 71.5, and 80%, respectively. We showed a positive correlation between the Glücksberg scoring system and WCE ( rho = 0.543, p = 0.036) and pCLE ( rho = 0.727, p = 0.002) but not with standard histology ( rho = 0.481, p = 0.069). Conclusions: The results from this pilot study suggest that novel methods such as pCLE and WCE could be part of a mini‐invasive algorithm for early detection of GI‐GVHD.