| Capsule endoscopy in nonresponsive celiac disease. | |
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MedLine Citation:
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PMID: 21835400 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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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. |
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Authors:
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David S Atlas; Alberto Rubio-Tapia; Carol T Van Dyke; Brian D Lahr; Joseph A Murray |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-8-9 |
Journal Detail:
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Title: Gastrointestinal endoscopy Volume: - ISSN: 1097-6779 ISO Abbreviation: - Publication Date: 2011 Aug |
Date Detail:
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Created Date: 2011-8-12 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0010505 Medline TA: Gastrointest Endosc Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved. |
Affiliation:
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Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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