Document Detail

Capsule endoscopy in adult celiac disease: a potential role in equivocal cases of celiac disease?
MedLine Citation:
PMID:  23200728     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: There have been limited studies evaluating capsule endoscopy (CE) in equivocal celiac disease (CD).
OBJECTIVE: To determine the role CE may have in equivocal CD cases, compared with patients with biopsy-proven and serology-proven CD who have persisting symptoms.
DESIGN: Prospective cohort study.
SETTING: University hospital.
PATIENTS: A total of 62 patients with equivocal CD and 69 patients with nonresponsive CD.
MAIN OUTCOME MEASUREMENTS: Diagnostic yield of CE in equivocal cases and accuracy of mucosal abnormality detection in patients with nonresponsive CD.
RESULTS: Equivocal cases (n = 62) were divided into two subgroups: group A (antibody-negative villous atrophy, n = 32) and group B (Marsh 1-2 changes, n = 30). In group A, CE secured a diagnosis of CD or Crohn's disease in 28% (9/32), significantly higher than the diagnostic yield in group B (7%; P = .044). In patients with CD with persisting symptoms, significant CE findings were identified in 12% (8/69), including 2 cases of enteropathy-associated lymphoma, 4 type 1 refractory disease cases, 1 polypoidal mass histologically confirmed to be a fibroepithelial polyp, and 1 case of ulcerative jejunitis. This outcome was significantly lower than the diagnostic yield of CE in antibody-negative villous atrophy (P = .048).
LIMITATIONS: Single center.
CONCLUSION: There have been no previous reports systematically evaluating equivocal CD by using CE. The diagnostic yield of CE in patients with antibody-negative villous atrophy is better than that of CE in patients with CD with persisting symptoms. We advocate the use of CE in equivocal cases, particularly in patients with antibody-negative villous atrophy.
Matthew Kurien; Kate E Evans; Imran Aziz; Reena Sidhu; Kaye Drew; Thea L Rogers; Mark E McAlindon; David S Sanders
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2012-11-30
Journal Detail:
Title:  Gastrointestinal endoscopy     Volume:  77     ISSN:  1097-6779     ISO Abbreviation:  Gastrointest. Endosc.     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-15     Completed Date:  2013-06-27     Revised Date:  2013-09-12    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  227-32     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.
Department of Gastroenterology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, South Yorkshire, United Kingdom.
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MeSH Terms
Aged, 80 and over
Biological Markers / blood
Capsule Endoscopy*
Celiac Disease / diagnosis*,  immunology
Cohort Studies
Crohn Disease / diagnosis
Diagnosis, Differential
HLA-DQ Antigens / blood
Immunoglobulin A / blood
Middle Aged
Prospective Studies
Reg. No./Substance:
0/Biological Markers; 0/HLA-DQ Antigens; 0/Immunoglobulin A
Comment In:
Gastrointest Endosc. 2013 Aug;78(2):381   [PMID:  23867376 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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