Document Detail


Capsule endoscopy in nonresponsive celiac disease.
MedLine Citation:
PMID:  21835400     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Nonresponsive celiac disease (CD) is defined by persistent or recurrent symptoms, common after treatment with a gluten-free diet (GFD).
OBJECTIVE: To evaluate the utility of capsule endoscopy (CE) in nonresponsive CD.
DESIGN: Case-control study.
SETTING: Tertiary-care center.
PATIENTS: Forty-two consecutive patients with nonresponsive CD and 84 age- and sex-matched CD-free controls who underwent CE were included. In addition, capsules taken after treatment with a GFD were retrospectively evaluated in 30 patients with uncomplicated CD.
INTERVENTION: CE.
MAIN OUTCOME MEASUREMENTS: Diagnostic accuracy of CE for the detection of mucosal abnormalities in nonresponsive CD.
RESULTS: Macroscopic features of villous atrophy were detected in 13 of 42 patients (31%) with nonresponsive CD compared with none among 84 CD-free controls and 14 of 30 patients (47%) with uncomplicated CD. Among nonresponsive CD cases, the overall sensitivity and specificity of CE for the detection of any degree of villous atrophy as graded by histology were 56% and 85%, respectively. Single or multiple erosions/ulcerations of the gut were observed in 19% of nonresponsive CD patients, 18% of CD-free controls, and 31% of patients with uncomplicated CD (P = .35). The presence of erosions/ulcerations was associated with increased aspirin/nonsteroidal anti-inflammatory drug use in nonresponsive CD (P =.05). Two severe complications (ulcerative jejunitis and adenocarcinoma) were detected by CE in nonresponsive CD.
LIMITATIONS: Single-center, retrospective study.
CONCLUSIONS: Mucosal abnormalities were observed by CE in patients with both nonresponsive CD and uncomplicated CD. CE can detect severe complications in patients with nonresponsive CD.
Authors:
David S Atlas; Alberto Rubio-Tapia; Carol T Van Dyke; Brian D Lahr; Joseph A Murray
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2011-08-11
Journal Detail:
Title:  Gastrointestinal endoscopy     Volume:  74     ISSN:  1097-6779     ISO Abbreviation:  Gastrointest. Endosc.     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-05     Completed Date:  2012-04-26     Revised Date:  2013-06-28    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1315-22     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.
Affiliation:
Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.
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MeSH Terms
Descriptor/Qualifier:
Capsule Endoscopy / methods*
Celiac Disease / diagnosis*,  diet therapy
Diagnosis, Differential
Diet, Gluten-Free / methods*
Female
Humans
Intestinal Mucosa / pathology*
Male
Middle Aged
Prognosis
Retrospective Studies
Sensitivity and Specificity
Treatment Failure
Grant Support
ID/Acronym/Agency:
DK57892/DK/NIDDK NIH HHS; R01 DK057892/DK/NIDDK NIH HHS; T32 AI-07047/AI/NIAID NIH HHS; T32 AI007047/AI/NIAID NIH HHS
Comments/Corrections
Comment In:
Gastrointest Endosc. 2011 Dec;74(6):1323-4   [PMID:  22136777 ]

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


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