TY - JOUR
T1 - Role of capsule endoscopy in suspected celiac disease
T2 - A European multi-centre study
AU - Luján-Sanchis, Marisol
AU - Pérez-Cuadrado-Robles, Enrique
AU - García-Lledó, Javier
AU - Fernández, José Francisco Juanmartiñena
AU - Elli, Luca
AU - Jiménez-García, Victoria Alejandra
AU - Egea-Valenzuela, Juan
AU - Valle-Muñoz, Julio
AU - Carretero-Ribón, Cristina
AU - Fernández-Urién-Sainz, Ignacio
AU - López-Higueras, Antonio
AU - Alonso-Lázaro, Noelia
AU - Sanjuan-Acosta, Mileidis
AU - Sánchez-Ceballos, Francisco
AU - Rosa, Bruno
AU - González-Vázquez, Santiago
AU - Branchi, Federica
AU - Ruano-Díaz, Lucía
AU - Prieto-De-Frías, César
AU - Pons-Beltrán, Vicente
AU - Borque-Barrera, Pilar
AU - González-Suárez, Begoña
AU - Xavier, Sofía
AU - Argüelles-Arias, Federico
AU - Herrerías-Gutiérrez, Juan Manuel
AU - Pérez-Cuadrado-Martínez, Enrique
AU - Sempere-García-Argüelles, Javier
PY - 2017/1/28
Y1 - 2017/1/28
N2 - 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.
AB - 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.
KW - Antitransglutaminase antibodies
KW - Capsule endoscopy
KW - Celiac disease
KW - Gluten-free diet
KW - Nonceliac gluten sensitivity
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U2 - 10.3748/wjg.v23.i4.703
DO - 10.3748/wjg.v23.i4.703
M3 - Article
C2 - 28216978
AN - SCOPUS:85010876732
VL - 23
SP - 703
EP - 711
JO - World Journal of Gastroenterology
JF - World Journal of Gastroenterology
SN - 1007-9327
IS - 4
ER -