Gastric graft-versus-host disease revisited: does proton pump inhibitor therapy affect endoscopic gastric biopsy interpretation?

The American Journal of Surgical Pathology
Derek C WelchKay Washington

Abstract

Accurate diagnosis of gastrointestinal graft-versus-host disease (GvHD) is important, as it contributes significantly to postallogeneic stem cell transplant (SCT) morbidity and mortality. To test the hypothesis that proton pump inhibitor (PPI) therapy may interfere with histologic evaluation of gastric GvHD by inducing apoptosis, we evaluated epithelial apoptotic body counts in antral and fundic biopsies from SCT recipients and control patients, both taking and not taking PPIs at the time of endoscopic biopsy. Hematoxylin and eosin-stained slides of gastric biopsies from 130 patients (75 allogeneic SCT with GvHD on clinical and histologic grounds, and a comparison group of 55 age- and sex-matched nontransplant patients with histologically normal gastric biopsies) were reviewed. The groups were further stratified into patients taking (PPI+) and not taking PPIs (PPI-) at the time of biopsy. Apoptotic bodies (AB)/10 (400 x) high power fields (HPF) were quantified for each case. Mean apoptotic body counts were then calculated for each case group. Seventy antral cases (31 control and 39 transplant) were also evaluated via gastrin immunohistochemistry, and the mean number of gastrin positive cells/400 x HPF calculated. In the PPI- gr...Continue Reading

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Citations

Jun 23, 2009·The American Journal of Surgical Pathology·Thong NguyenElizabeth Montgomery
Apr 15, 2008·World Journal of Gastroenterology : WJG·Chun-Fang XuDe-Pei Wu
Jun 2, 2016·American Journal of Clinical Pathology·Marcela SalomaoAntonia Sepulveda
May 27, 2017·Hematological Oncology·Kathrin RiegerChristian Bojarski
Jan 10, 2006·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Howard M ShulmanGeorgia B Vogelsang
Sep 12, 2013·International Journal of Surgical Pathology·Giovanni De PetrisDora Lam-Himlin
Oct 19, 2017·Journal of Pediatric Gastroenterology and Nutrition·Thomas MårtenssonBritt Gustafsson
Sep 28, 2017·Nature Reviews. Gastroenterology & Hepatology·Steven NaymagonJames Ferrara
Feb 7, 2018·Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc·Nicole C Panarelli, Rhonda K Yantiss
Sep 10, 2014·Histopathology·Newton A C S Wong
Dec 21, 2019·Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc·Mohamed MostafaCatherine E Hagen
Mar 7, 2019·Archives of Pathology & Laboratory Medicine·Nathalie MouradVictoria A Marcus
Mar 17, 2009·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Rami B IbrahimJoseph P Uberti

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