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. Author manuscript; available in PMC: 2018 Nov 18.
Published in final edited form as: Nat Rev Gastroenterol Hepatol. 2017 Sep 27;14(12):711–726. doi: 10.1038/nrgastro.2017.126

Table 3 |.

Differential diagnosis for acute GVHD of the gastrointestinal tract

Aetiology Differential diagnosis
Anorexia, dysphagia, nausea and vomiting
Iatrogenic

  • Conditioning chemotherapy (cyclophosphamide, busulfan, cytarabine, melphalan)

  • Immunosuppressants

  • Radiation

  • Antibiotics

  • Opioids

  • Pill-induced oesophagitis
Infectious

  • Cytomegalovirus, HSV, VZV

  • Candida

  • Bacterial
Inflammatory

  • Peptic oesophagitis

  • Peptic stricture
Anatomical

  • Bowel obstruction (mass lesion, haematoma)

  • Ileus, colonic pseudo-obstruction
Abdominal pain
Iatrogenic

  • Conditioning chemotherapy-induced enteritis

  • Medication-induced constipation, ileus
Infectious

  • Bacterial

  • Viral

  • Parasitic

  • Liver abscess
Inflammatory

  • Peptic ulcer disease

  • Typhlitis

  • EBV lymphoproliferative disease
Hepatic, biliary, pancreatic

  • Acute pancreatitis

  • Acute (acalculous) cholecystitis

  • Ascending cholangitis

  • Sinusoidal obstruction syndrome
Vascular

  • Haematoma

  • Intestinal infarction
Genitourinary

  • Haemorrhagic cystitis

  • Infectious cystitis

  • Nephrolithiasis
Diarrhoea
Iatrogenic

  • Conditioning chemotherapy (melphalan, cytarabine, alkylating agents)

  • Immunosuppressants (tacrolimus, MMF)

  • Antibiotics

  • Magnesium supplements
Infectious

  • Cytomegalovirus, EBV, adenovirus, rotavirus, astrovirus, norovirus

  • Enteric pathogens, MAC, Clostridium septicum

  • Clostridium difficile

  • Giardia lamblia, Cryptosporidium hominis, Entamoeba histolytica, Strongyloides stercoralis
Other

  • Cord colitis syndrome

  • Thrombotic microangiopathy

  • Disaccharidase deficiency

  • Bile salt malabsorption

  • Pancreatic insufficiency

EBV, Epstein–Barr virus; HSV, herpes simplex virus; MAC, Mycobacterium avium complex; MMF, mycophenolate mofetil; VZV, varicella zoster virus.