| A key role for abdominal ultrasound examination in "difficult" diagnoses of celiac disease. | |
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MedLine Citation:
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PMID: 20235005 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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PURPOSE: To evaluate the usefulness of abdominal ultrasound examination (US) for the diagnostic workup of cases of suspected CD involving negative serum antibodies and difficult diagnosis. MATERIALS AND METHODS: 524 consecutive patients with symptoms of suspected CD underwent an extensive diagnostic workup. 76 (14 %) were excluded since they were positive for serum anti-tTG and/or EmA antibodies. 377 were excluded since they were diagnosed with something other than CD or did not have the alleles encoding for HLA DQ 2 or DQ 8. A diagnosis of CD with negative serum antibodies was probable in 71 patients who underwent abdominal US and duodenal biopsy for histology evaluation. RESULTS: Intestinal histology and subsequent clinical and histological follow-up confirmed the CD diagnosis in 12 patients (GROUP 1) and excluded it in 59 subjects (GROUP 2). Abdominal US showed that the presence of dilated bowel loops and a thickened small bowel wall had a sensitivity of 83 % and a negative predictive value (NPV) of 95 % in CD diagnosis. Furthermore, in 11 of the 12 CD seronegative patients there was at least one of these two abdominal US signs. Therefore, considering the presence of one of these two signs, abdominal US sensitivity increased to 92 % and NPV to 98 %. CONCLUSION: Abdominal US is useful in the diagnostic workup of patients with a high clinical suspicion of CD but with negative serology. |
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Authors:
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M Soresi; G Pirrone; L Giannitrapani; G Iacono; L Di Prima; E La Spada; G Di Fede; G Ambrosiano; G Montalto; A Carroccio |
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Publication Detail:
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Type: Journal Article Date: 2010-03-16 |
Journal Detail:
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Title: Ultraschall in der Medizin (Stuttgart, Germany : 1980) Volume: 32 Suppl 1 ISSN: 1438-8782 ISO Abbreviation: Ultraschall Med Publication Date: 2011 Jan |
Date Detail:
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Created Date: 2011-01-12 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8303585 Medline TA: Ultraschall Med Country: Germany |
Other Details:
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Languages: eng Pagination: S53-61 Citation Subset: IM |
Copyright Information:
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© Georg Thieme Verlag KG Stuttgart · New York. |
Affiliation:
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Department of Clinical Medicine and Emerging Pathologies, University of Palermo, Palermo, Italy. |
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