This page tells you about how doctors diagnose graft versus host disease (GVHD). You can find out about
Although your symptoms may suggest that you have GVHD, you will need to have tests to confirm this. The main test for GVHD is to take a sample (a biopsy) of the affected area.
You may need to see different specialists for some of these tests. For example, if you have skin GVHD, your doctor may refer you to a skin specialist (dermatologist).
The doctor removes a small amount of tissue from the affected part of your body. They send the sample to the lab so that a specialist doctor called a pathologist can examine it under a microscope. It may take a while to get the results of your biopsy.
How you have a biopsy depends on which part of your body is involved. You might have a skin biopsy or a liver biopsy. If you need a biopsy of your stomach or bowel your doctor will recommend that you have an endoscopy.
The doctor gives you a local anaesthetic injection to numb your skin. Then they remove a small amount of the affected skin and put a dressing over the biopsy site.
You usually have an ultrasound or CT scan at the same time as a liver biopsy. The doctor uses the images from the CT or ultrasound scan to guide the biopsy needle into the right place in the liver. After giving you some local anaesthetic, the doctor puts a needle through your skin and into the affected part of the liver to take tissue samples. After a liver biopsy, you will have to stay in hospital for a few hours or possibly overnight. The liver has a very rich blood supply and there is a risk of bleeding afterwards, so your nurse will monitor you closely.
If your doctor thinks you have GVHD in your digestive system you might need an endoscopy. For this test the doctor uses a tube to look at the inside of your food pipe (oesophagus), stomach or bowel. You might have a tube put down into your stomach (gastroscopy). Or a tube into your back passage to look at your bowel (sigmoidoscopy or colonoscopy). The doctor can take a biopsy during the endoscopy.
You may need an X-ray or CT scan of your lungs. This is painless and you don’t need any preparation for it. Or you might have an ultrasound scan of your liver to see if there are any signs of GVHD. There is more information about having a CT scan and about ultrasound scans in the cancer tests section.
If you have symptoms of GVHD in the lungs, you have tests to check how well your lungs are working. These tests check how much air you can breathe in and out, and how quickly.
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