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Endoscopic evaluation for cytomegalovirus enterocolitis after allogeneic haematopoietic stem cell transplantation
  1. Y Kakugawa1,
  2. M Kami2,
  3. T Kozu3,
  4. N Kobayashi3,
  5. H Shoda3,
  6. T Matsuda3,
  7. Y Saito3,
  8. I Oda3,
  9. T Gotoda3,
  10. S Mori4,
  11. R Tanosaki4,
  12. N Murashige4,
  13. T Hamaki4,
  14. S Mineishi4,
  15. Y Takaue4,
  16. T Shimoda5,
  17. D Saito6
  1. 1Endoscopy Division, the National Cancer Centre Hospital, Tokyo, Japan
  2. 2Haematopoietic Stem Cell Transplantation Unit, the National Cancer Centre Hospital, Tokyo, Japan
  3. 3Endoscopy Division, the National Cancer Centre Hospital, Tokyo, Japan
  4. 4Haematopoietic Stem Cell Transplantation Unit, the National Cancer Centre Hospital, Tokyo, Japan
  5. 5Pathological Division, the National Cancer Centre Hospital, Tokyo, Japan
  6. 6Endoscopy Division, the National Cancer Centre Hospital, Tokyo, Japan
  1. Correspondence to:
    Dr Y Kakugawa
    Endoscopy Division, the National Cancer Centre Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan; yakakuga{at}ncc.go.jp

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Cytomegalovirus (CMV) disease and graft versus host disease (GVHD) are serious complications after allogeneic haematopoietic stem cell transplantation (allo-SCT).1 As clinical manifestations overlap,2 it is difficult to make an early and accurate diagnosis of CMV enterocolitis in patients with gastrointestinal GVHD. This study aimed to estimate the usefulness of endoscopic examination for CMV enterocolitis after allo-SCT.

Between 1999 and 2003, 425 patients received allo-SCT at the National Cancer Centre Hospital. Eighty seven patients with gastrointestinal symptoms underwent colonoscopy, and gastrointestinal GVHD was diagnosed in 75 patients. Thirty three of these patients with a median age of 46 years (range 4–67) who had persistent diarrhoea and/or abdominal pain despite optimal treatment underwent repeat colonoscopy. After informed consent was obtained, we examined from the terminal ileum to the rectum by colonoscopy. Biopsy …

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