Graft‐versus‐host disease‐like reactions in the gastrointestinal tract in a patient with SARS‐CoV‐2 infection

Abstract

potential of these metaplastic intraductal lesions remains unclear, complicating selection of the most optimal surveillance strategy.While the usefulness of dedicated DSOC-compatible snares has been illustrated in the context of migrated plastic stents, 5 our case highlights its therapeutic potential in treating intraductal neoplasia.

Squamous Metaplasia of the Colon Following Severe COVID-19

“…Endoscopic findings such as extensive mucosal sloughing in the small intestine and colon have been reported [3,4]. In addition, histopathological findings such as mucosal erosion, crypt loss, edema, lymphocyte infiltration, and enterocyte apoptosis have been reported [3,4]. Similar to that in previous reports, colonoscopy showed completely detached mucosa throughout the colon in our case.…”

“…Similar to that in previous reports, colonoscopy showed completely detached mucosa throughout the colon in our case. Histopathological findings revealed inflammatory cell infiltration in the lamina propria, similar to those in previous reports [3,4]. However, the findings on the surface were completely different.…”

“…A few reports have revealed endoscopic and histopathologic findings in patients with COVID-19 presenting with profuse diarrhea. Endoscopic findings such as extensive mucosal sloughing in the small intestine and colon have been reported [3,4]. In addition, histopathological findings such as mucosal erosion, crypt loss, edema, lymphocyte infiltration, and enterocyte apoptosis have been reported [3,4].…”

“…Although some patients with severe COVID-19 experience refractory diarrhea, only a few reports have revealed endoscopic findings for investigation of the etiology. Endoscopic findings such as mucosal detachment and edematous mucosa resembling graft-versushost disease have been reported, along with pathological findings such as inflammatory cell infiltration and atrophy of the glandular fossa [3,4]. Such cases can respond to treatment with corticosteroids with or without infliximab and fluid resuscitation, and, consequently, diarrhea can be resolved [3,4].…”

Acute gastrointestinal graft-versus-host disease with CMV and EBV superinfection in a patient with COVID-19

“…However, superinfection with both CMV and EBV is unusual and could have contributed to symptom severity and poor outcome. The presence of SARS-CoV2 infection was also relevant, as GVHD-like reactions in the gastrointestinal tract in patients with COVID-19 with similar endoscopic and histological findings and favorable response to corticosteroid have been described, perhaps related to similar cytokine-storm related events (5), suggesting that GVHD and COVID-19 can synergistically promote colonic immune-mediated inflammation after HSCT.…”