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Prediction of esophageal and gastric histology by macroscopic diagnosis during upper endoscopy in pediatric celiac disease

AIM: To determine the sensitivity of macroscopic appearance for predicting histological diagnosis at sites other than duodenum in pediatric celiac disease (CD). METHODS: Endoscopic and histologic findings in pediatric patients undergoing upper endoscopy for first-time diagnosis of CD at Stollery Chi...

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Autores principales: Boschee, Erin D, Yap, Jason Y K, Turner, Justine M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5292338/
https://www.ncbi.nlm.nih.gov/pubmed/28216971
http://dx.doi.org/10.3748/wjg.v23.i4.646
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author Boschee, Erin D
Yap, Jason Y K
Turner, Justine M
author_facet Boschee, Erin D
Yap, Jason Y K
Turner, Justine M
author_sort Boschee, Erin D
collection PubMed
description AIM: To determine the sensitivity of macroscopic appearance for predicting histological diagnosis at sites other than duodenum in pediatric celiac disease (CD). METHODS: Endoscopic and histologic findings in pediatric patients undergoing upper endoscopy for first-time diagnosis of CD at Stollery Children’s Hospital from 2010-2012 were retrospectively reviewed. RESULTS: Clinical charts from 140 patients were reviewed. Esophageal and gastric biopsies were taken in 54.3% and 77.9% of patients, respectively. Endoscopic appearance was normal in the esophagus and stomach in 75% and 86.2%. Endoscopic esophageal diagnoses were eosinophilic esophagitis (EE) (11.8%), esophagitis (7.9%), glycogenic acanthosis (1.3%) and non-specific abnormalities (3.9%). Endoscopic gastric diagnoses were gastritis (8.3%), pancreatic rest (0.9%), and non-specific abnormalities (4.6%). Histology was normal in 76.3% of esophageal and 87.2% of gastric specimens. Abnormal esophageal histology was EE (10.5%), esophagitis (10.5%), glycogenic acanthosis (1.3%) and non-specific (1.3%). Gastritis was reported in 12.8% of specimens. Sensitivity and specificity of normal endoscopy for predicting normal esophageal histology was 86.2% and 61.1%, and for normal gastric histology was 87.4% and 21.4%. CONCLUSION: In the absence of macroscopic abnormalities, routine esophageal and gastric biopsy during endoscopy for pediatric CD does not identify major pathologies. These findings have cost and time saving implications for clinical practice.
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spelling pubmed-52923382017-02-17 Prediction of esophageal and gastric histology by macroscopic diagnosis during upper endoscopy in pediatric celiac disease Boschee, Erin D Yap, Jason Y K Turner, Justine M World J Gastroenterol Retrospective Study AIM: To determine the sensitivity of macroscopic appearance for predicting histological diagnosis at sites other than duodenum in pediatric celiac disease (CD). METHODS: Endoscopic and histologic findings in pediatric patients undergoing upper endoscopy for first-time diagnosis of CD at Stollery Children’s Hospital from 2010-2012 were retrospectively reviewed. RESULTS: Clinical charts from 140 patients were reviewed. Esophageal and gastric biopsies were taken in 54.3% and 77.9% of patients, respectively. Endoscopic appearance was normal in the esophagus and stomach in 75% and 86.2%. Endoscopic esophageal diagnoses were eosinophilic esophagitis (EE) (11.8%), esophagitis (7.9%), glycogenic acanthosis (1.3%) and non-specific abnormalities (3.9%). Endoscopic gastric diagnoses were gastritis (8.3%), pancreatic rest (0.9%), and non-specific abnormalities (4.6%). Histology was normal in 76.3% of esophageal and 87.2% of gastric specimens. Abnormal esophageal histology was EE (10.5%), esophagitis (10.5%), glycogenic acanthosis (1.3%) and non-specific (1.3%). Gastritis was reported in 12.8% of specimens. Sensitivity and specificity of normal endoscopy for predicting normal esophageal histology was 86.2% and 61.1%, and for normal gastric histology was 87.4% and 21.4%. CONCLUSION: In the absence of macroscopic abnormalities, routine esophageal and gastric biopsy during endoscopy for pediatric CD does not identify major pathologies. These findings have cost and time saving implications for clinical practice. Baishideng Publishing Group Inc 2017-01-28 2017-01-28 /pmc/articles/PMC5292338/ /pubmed/28216971 http://dx.doi.org/10.3748/wjg.v23.i4.646 Text en ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Retrospective Study
Boschee, Erin D
Yap, Jason Y K
Turner, Justine M
Prediction of esophageal and gastric histology by macroscopic diagnosis during upper endoscopy in pediatric celiac disease
title Prediction of esophageal and gastric histology by macroscopic diagnosis during upper endoscopy in pediatric celiac disease
title_full Prediction of esophageal and gastric histology by macroscopic diagnosis during upper endoscopy in pediatric celiac disease
title_fullStr Prediction of esophageal and gastric histology by macroscopic diagnosis during upper endoscopy in pediatric celiac disease
title_full_unstemmed Prediction of esophageal and gastric histology by macroscopic diagnosis during upper endoscopy in pediatric celiac disease
title_short Prediction of esophageal and gastric histology by macroscopic diagnosis during upper endoscopy in pediatric celiac disease
title_sort prediction of esophageal and gastric histology by macroscopic diagnosis during upper endoscopy in pediatric celiac disease
topic Retrospective Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5292338/
https://www.ncbi.nlm.nih.gov/pubmed/28216971
http://dx.doi.org/10.3748/wjg.v23.i4.646
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