{"doi":"10.31488/bjg.1000133","title":"Persistence of Gastric Metaplasia of the Terminal Ileum after Post-transplant Cytomegalovirus Ileitis and Graft-versus-Host Disease","abstract":"Gastric metaplasia is the change of native mucosa to gastric tissue outside of the stomach, a rare entity that is not well described in the literature and for which the clinical implications and management is not well understood. Herein, we describe a case of a patient with relapsed/refractory stage IVB Hodgkin lymphoma who underwent an allogeneic hematopoietic stem cell transplantation (HSCT) that was complicated by graft-versus-host disease (GVHD) requiring multiple lines of systemic immunosuppression as well as infections including cytomegalovirus (CMV). Endoscopy done to explore etiology of persistent gastrointestinal symptoms showed evidence of GVHD and CMV ileitis as well as gastric metaplasia in the terminal ileum. GVHD and CMV were both treated to resolution. Given the unknown implications of the metaplasia he underwent repeat colonoscopy for monitoring and on Day +859 post-HSCT still showed persistent gastric metaplasia with normal findings on endoscopy. The significance and natural history of gastric metaplasia in the terminal ileum is not well understood. We hypothesize that in this patient it is a reaction to tissue injury from GVHD as well as CMV ileitis. Close monitoring and repeat colonoscopy should be considered to ensure no progression to dysplasia, especially in the immunosuppressed post-HSCT patient.","journal":"British Journal of Gastroenterology","year":2022,"id":313931,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9511,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[],"reference_count":4,"raw_metadata":null,"created_at":"2026-07-19T00:33:48.490749Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}