Role of capsule endoscopy in suspected celiac disease: A European multi-centre study

Marisol Luján-Sanchis, Enrique Pérez-Cuadrado-Robles, Javier García-Lledó, José Francisco Juanmartiñena Fernández, Luca Elli, Victoria Alejandra Jiménez-García, Juan Egea-Valenzuela, Julio Valle-Muñoz, Cristina Carretero-Ribón, Ignacio Fernández-Urién-Sainz, Antonio López-Higueras, Noelia Alonso-Lázaro, Mileidis Sanjuan-Acosta, Francisco Sánchez-Ceballos, Bruno Rosa, Santiago González-Vázquez, Federica Branchi, Lucía Ruano-Díaz, César Prieto-De-Frías, Vicente Pons-BeltránPilar Borque-Barrera, Begoña González-Suárez, Sofía Xavier, Federico Argüelles-Arias, Juan Manuel Herrerías-Gutiérrez, Enrique Pérez-Cuadrado-Martínez, Javier Sempere-García-Argüelles

Research output: Contribution to journalArticlepeer-review

Abstract

AIM To analyze the diagnostic yield (DY), therapeutic impact (TI) and safety of capsule endoscopy (CE). METHODS This is a multi-centre, observational, analytical, retrospective study. A total of 163 patients with suspicion of celiac disease (CD) (mean age = 46.4 ± 17.3 years, 68.1% women) who underwent CE from 2003 to 2015 were included. Patients were divided into four groups: seronegative CD with atrophy (Group- ?, n = 19), seropositive CD without atrophy (Group- ?, n = 39), contraindication to gastroscopy (Group-?, n = 6), seronegative CD without atrophy, but with a compatible context (Group-?, n = 99). DY, TI and the safety of CE were analysed. RESULTS The overall DY was 54% and the final diagnosis was villous atrophy (n = 65, 39.9%), complicated CD (n = 12, 7.4%) and other enteropathies (n = 11, 6.8%; 8 Crohn's). DY for groups ? to ? was 73.7%, 69.2%, 50% and 44.4%, respectively. Atrophy was located in duodenum in 24 cases (36.9%), diffuse in 19 (29.2%), jejunal in 11 (16.9%), and patchy in 10 cases (15.4%). Factors associated with a greater DY were positive serology (68.3% vs 49.2%, P = 0.034) and older age (P = 0.008). On the other hand, neither sex nor clinical presentation, family background, positive histology or HLA status were associated with DY. CE results changed the therapeutic approach in 71.8% of the cases. Atrophy was associated with a greater TI (92.3% vs 45.3%, P < 0.001) and 81.9% of the patients responded to diet. There was one case of capsule retention (0.6%). Agreement between CE findings and subsequent histology was 100% for diagnosing normal/other conditions, 70% for suspected CD and 50% for complicated CD. CONCLUSION CE has a high DY in cases of suspicion of CD and it leads to changes in the clinical course of the disease. CE is safe procedure with a high degree of concordance with histology and it helps in the differential diagnosis of CD.

Original languageEnglish
Pages (from-to)703-711
Number of pages9
JournalWorld Journal of Gastroenterology
Volume23
Issue number4
DOIs
Publication statusPublished - Jan 28 2017

Keywords

  • Antitransglutaminase antibodies
  • Capsule endoscopy
  • Celiac disease
  • Gluten-free diet
  • Nonceliac gluten sensitivity

ASJC Scopus subject areas

  • Gastroenterology

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