Document Detail


Capsule endoscopy in nonresponsive celiac disease.
MedLine Citation:
PMID:  21835400     Owner:  NLM     Status:  Publisher    
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:  JOURNAL ARTICLE     Date:  2011-8-9
Journal Detail:
Title:  Gastrointestinal endoscopy     Volume:  -     ISSN:  1097-6779     ISO Abbreviation:  -     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-8-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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, USA.
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