Diagnosing GvHD
To diagnose that you have GvHD you have further tests and investigations if you have symptoms of GvHD.
Diagnosing if you have GvHD
Your symptoms might suggest that you have GvHD but you still need to have tests to confirm this. To do this your doctor might take a sample (a biopsy) of the affected area.
You might 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. They are called a dermatologist.
Having a biopsy
The doctor removes a small sample of tissue from the affected part of your body. They send the sample to the laboratory. A specialist doctor called a pathologist looks at the tissue sample under a microscope. It may take a while to get the results of your biopsy.
The biopsy you have depends on which part of your body is involved. For example, you might need a skin biopsy or a liver biopsy.
Skin biopsy
The doctor gives you a 
injection to numb your skin. Then they remove a small sample of the affected skin and put a dressing over the biopsy site.
Liver biopsy
You usually have an or 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. The doctor takes tissue samples.
After a liver biopsy you 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.
There are other ways to take liver biopsies that you can read on our liver biopsy page.
Endoscopy
An endoscopy is a test that looks inside the body. The endoscope is a long flexible tube which has a tiny camera and light on the end of it. During this test the doctor can take biopsies of abnormal areas.
There are many types of endoscopes, the name of the test you have will depends on which part of the body the doctor is looking at.
You might need an endoscopy if your doctor suspects you have GvHD in your digestive system. The digestive system includes your:
- mouth
- food pipe (oesophagus)
- stomach
- large and small bowel (intestines)
- back passage (rectum)
A gastroscopy is a type of endoscopy that looks at the inside of your oesophagus, stomach and the first part of your small bowel. It’s also sometimes called an oesophago gastric duodenoscopy (OGD).
A sigmoidoscopy or colonoscopy are types of endoscopies to look at your large bowel.
Other possible tests and scans
X-ray
An x-ray uses small amounts of radiation to take pictures of the inside of your body. You may need an x-ray of your lungs to check for changes. This is painless and you don’t need any preparation for it.
CT scan
CT scans use x-rays and a computer to create detailed picture of the inside of your body. It takes pictures from different angles. The computer puts them together to make a 3 dimensional (3D) image. Some of the areas of the body you might have a CT scan are the lungs and digestive system to look for signs of GvHD.
Ultrasound scan
An ultrasound scan uses high frequency sound waves to create a picture of the inside of your body. You might have an ultrasound scan of your liver to see if there are any signs of GvHD.
Lung function tests
If you have symptoms of GvHD in the lungs, you might have tests to check how well your lungs are working.
There are different types of lung function tests and depending on the type of test you have will depend on what they will measure. The different tests look at:
- how well your lungs take in oxygen and remove
carbon dioxide from the blood - how much air you breath in and out and how quickly
- how big your lungs are
- if there is narrowing in your breathing tubes
There are other tests you might have to check for signs of GvHD.
