Journal of Gastrointestinal & Digestive System
Open Access

Abstract

Graft-versus-host-disease (GVHD) is a common complication of hematopoietic stem-cell transplant with reported incidence of 30% to 50% in HLA-match recipients and up to 50%-70% in unmatched recipients. GVHD can also be seen as a complication of thymus transplantation or blood transfusions in immunocompromised patients. Although it can involve any organ, but commonly involves the skin, liver and gastrointestinal tract. GVHD results from donor T-cells reacting to recipient antigen leading to a cascade of immune-modulated events resulting in damage to involved host-organ(s). There are two forms of the disease: acute GVHD which occurs within first one-hundred days post-transplant or chronic GVHD which occurs after one-hundred days post-transplant. Our exhibit is a case-based review of gastrointestinal tract and hepatobiliary manifestations of GVHD. We will review common clinical presentation, pathophysiology, histology, and demographics of gastrointestinal and hepatobiliary GVHD. There will be special emphasis on imaging (CT, MRI, and endoscopy findings) along with histopathology correlation of the imaging findings. Additionally, there will be extensive case-based discussion on differential diagnostic considerations including: pseudomembranous colitis, typhilitis, cytomegalovirus colitis, radiation enteritis, posttranplantation lymphoproliferative disorder (PTLD), shock-bowel (hypoperfusion complex), viral hepatitis (CMV, HSV, VZV, EBV), thromboembolism, and drug induced (bactrim, itraconzole, chemotherapy agents, etc.). Clinical features, pathophysiology, imaging findings along with histologic correlation, treatment and prognosis of these differential diagnoses will be discussed. By the conclusion of this presentation, the physician should have a better understanding of gastrointestinal and hepatobiliary GVHD and characteristic imaging findings. Although GVHD carries a broad differential diagnosis, it can be narrowed utilizing age, clinical features, imaging (radiologic and endoscopy findings).

Biography

Maryam Gul completed his M.D. in Internal Medicine Resident at Winthrop University Hospital. He graduated from St. George's University School of Medicine in 2012 and from University of California, Los Angeles in 2007 in Ecology Evolutionary Biology Major and Neuroscience Minor. She has two publications including meta-analysis study published in NEJM, 2010. Currently, she is working as first author on various retrospective studies on topics including: granulocytic sarcoma, craniofacial syndromes, and I-123 Ioflupane (DATscan) SPECT Imaging which will be presented at upcoming ASNR conference 2013 and extra-articular manifestation of crystalline arthritis to be presented at AUR 2013.