Short article: Capsule endoscopy in graft-versus-host disease

Area of Science:

• Gastroenterology
• Hematology
• Transplantation Medicine

Background:

• Gastrointestinal graft-versus-host disease (GVHD) diagnosis relies on conventional endoscopy and histopathology.
• The utility of capsule endoscopy (CE) in diagnosing GVHD remains unclear.
• Accurate GVHD diagnosis is crucial following allogeneic hematopoietic stem cell transplantation.

Purpose of the Study:

• To evaluate the diagnostic accuracy of capsule endoscopy (CE) for gastrointestinal GVHD.
• To compare CE findings with conventional endoscopy and histopathological data.
• To determine the diagnostic yield of CE in patients undergoing allogeneic stem cell transplantation.

Main Methods:

• Retrospective single-center study of 57 patients with GVHD.
• Patients underwent both capsule endoscopy (CE) and conventional endoscopy with histopathology.
• Duodenal histology served as the gold standard for comparison.

Main Results:

• Capsule endoscopy (CE) showed a significantly higher diagnostic yield (54.39%) than conventional endoscopy (28.07%).
• CE achieved high accuracy (82.46%) in predicting positive histology, with sensitivity of 86.21% and specificity of 78.57%.
• CE detected more mild-to-moderate lesions and identified pathology in 16% of patients with normal conventional endoscopy biopsies.

Conclusions:

• Capsule endoscopy (CE) is a valuable tool for diagnosing gastrointestinal GVHD, offering high accuracy and diagnostic yield.
• CE findings should be interpreted alongside clinical and histological data, particularly for mild-to-moderate GVHD stages.
• CE can detect lesions missed by conventional endoscopy, improving diagnostic capabilities in post-transplant patients.