Role of capsule endoscopy in suspected celiac disease: A European multi-centre study
Autor: | Noelia Alonso-Lázaro, Julio Valle-Muñoz, José Francisco Juanmartiñena Fernández, Enrique Pérez-Cuadrado-Martínez, Cristina Carretero-Ribón, Santiago Gonzalez-Vazquez, Ignacio Fernandez-Urien-Sainz, Pilar Borque-Barrera, César Prieto-de-Frías, Begoña González-Suárez, Marisol Luján-Sanchis, Luca Elli, Federica Branchi, Federico Argüelles-Arias, Victoria Alejandra Jiménez-García, Juan Egea-Valenzuela, Sofia Xavier, Antonio López-Higueras, Francisco Sanchez-Ceballos, Javier Sempere-Garcia-Argüelles, Enrique Pérez-Cuadrado-Robles, Vicente Pons-Beltrán, Juan Manuel Herrerías-Gutiérrez, Lucıa Ruano-Dıaz, Bruno Rosa, Mileidis San-Juan-Acosta, Javier Garcıa-Lledo |
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Přispěvatelé: | [Luján-Sanchis,M, Sempere-García-Argüelles,J] Digestive Diseases Unit, General University Hospital of Valencia, Valencia, Spain. [Pérez-Cuadrado-Robles,E, López-Higueras,A, Pérez-Cuadrado-Martínez,E] Small Bowel Unit, Hospital Morales Meseguer, Murcia, Spain. [Sánchez-Ceballos,F] Digestive Diseases Unit, General University Gregorio Marañón, Madrid, Spain. [Juanmartiñena Fernández JF, Fernández-Urién-Sainz,I] Unit of Gastroenterology and Endoscopy, Complejo Hospitalario de Navarra, Pamplona, Spain. [Elli,L, Branchi,F] Center for Prevention and Diagnosis of Celiac Disease, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. [Jiménez-García,VA, Argüelles-Arias,F, Herrerías-Gutiérrez,JM] Unit of Gastroenterology and Endoscopy, University Hospital Virgen Macarena, Sevilla, Spain. [Egea-Valenzuela,J] Gastroenterology Department, Hospital Virgen de la Arrixaca, Murcia, Spain. [Valle-Muñoz,J, Ruano-Díaz,I] Department of Gastroenterology, Complejo Hospitalario de Toledo, Toledo, Spain. [Carretero-Ribón,C, González-Vázquez,S, Prieto-De-Frías,C] Department of Gastroenterology, University of Navarra Clinic, Pamplona, Spain. [Alonso-Lázaro,N, Pons-Beltrán,V] Endoscopy Digestive Unit, Digestive Diseases Area, Universitari i Politècnic la Fe Hospital, Valencia, Spain. [Sanjuan-Acosta,M, Borque-Barrera,P] Digestive Diseases Unit, University Hospital Nuestra Señora de Candelaria, Tenerife, Spain. [Sánchez-Ceballos,F] Digestive Diseases Unit, Clinical Hospital San Carlos, Madrid, Spain. [Rosa,B, Xavier,S] Digestive Diseases Unit, Hospital da Senhora da Oliveira - Guimarães, Cutileiros, Portugal. [González-Suárez,B] Endoscopy Digestive Unit, Hospital Clinic de Barcelona, Barcelona, Spain. |
Rok vydání: | 2017 |
Předmět: |
Male
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Zdroj: | World Journal of Gastroenterology WORLD JOURNAL OF GASTROENTEROLOGY r-IIS La Fe. Repositorio Institucional de Producción Científica del Instituto de Investigación Sanitaria La Fe instname Repositorio Institucional de la Consejería de Sanidad de la Comunidad de Madrid Consejería de Sanidad de la Comunidad de Madrid |
ISSN: | 1007-9327 |
Popis: | 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. © The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved. Yes |
Databáze: | OpenAIRE |
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