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author Luján-Sanchis, Marisol
Pérez-Cuadrado-Robles, Enrique
García-Lledó, Javier
Juanmartiñena Fernández, José-Francisco
Elli, Luca
Jiménez-García, Victoria-Alejandra
Egea-Valenzuela, Juan
Valle-Muñoz, Julio
Carretero-Ribón, Cristina
Fernández-Urién-Sainz, Ignacio
López-Higueras, Antonio
Alonso-Lázaro, Noelia
Sanjuan-Acosta, Mileidis
Sánchez-Ceballos, Francisco
Rosa, Bruno
González-Vázquez, Santiago
Branchi, Federica
Ruano-Díaz, Lucía
Prieto-de-Frías, César
Pons-Beltrán, Vicente
Borque-Barrera, Pilar
González-Suárez, Begoña
Xavier, Sofía
Argüelles-Arias, Federico
Herrerías-Gutiérrez, Juan-Manuel
Pérez-Cuadrado-Martínez, Enrique
Sempere-García-Argüelles, Javier
author_facet Luján-Sanchis, Marisol
Pérez-Cuadrado-Robles, Enrique
García-Lledó, Javier
Juanmartiñena Fernández, José-Francisco
Elli, Luca
Jiménez-García, Victoria-Alejandra
Egea-Valenzuela, Juan
Valle-Muñoz, Julio
Carretero-Ribón, Cristina
Fernández-Urién-Sainz, Ignacio
López-Higueras, Antonio
Alonso-Lázaro, Noelia
Sanjuan-Acosta, Mileidis
Sánchez-Ceballos, Francisco
Rosa, Bruno
González-Vázquez, Santiago
Branchi, Federica
Ruano-Díaz, Lucía
Prieto-de-Frías, César
Pons-Beltrán, Vicente
Borque-Barrera, Pilar
González-Suárez, Begoña
Xavier, Sofía
Argüelles-Arias, Federico
Herrerías-Gutiérrez, Juan-Manuel
Pérez-Cuadrado-Martínez, Enrique
Sempere-García-Argüelles, Javier
author_sort Luján-Sanchis, Marisol
collection PubMed
description AIM: To analyze the diagnostic yield (DY), therapeutic impact (TI) and safety of capsule endoscopy (CE). METHODS: This is a multi-centre, observational, analytical, retrospective study. A total of 163 patients with suspicion of celiac disease (CD) (mean age = 46.4 ± 17.3 years, 68.1% women) who underwent CE from 2003 to 2015 were included. Patients were divided into four groups: seronegative CD with atrophy (Group-I, n = 19), seropositive CD without atrophy (Group-II, n = 39), contraindication to gastroscopy (Group-III, n = 6), seronegative CD without atrophy, but with a compatible context (Group-IV, n = 99). DY, TI and the safety of CE were analysed. RESULTS: The overall DY was 54% and the final diagnosis was villous atrophy (n = 65, 39.9%), complicated CD (n = 12, 7.4%) and other enteropathies (n = 11, 6.8%; 8 Crohn’s). DY for groups I to IV was 73.7%, 69.2%, 50% and 44.4%, respectively. Atrophy was located in duodenum in 24 cases (36.9%), diffuse in 19 (29.2%), jejunal in 11 (16.9%), and patchy in 10 cases (15.4%). Factors associated with a greater DY were positive serology (68.3% vs 49.2%, P = 0.034) and older age (P = 0.008). On the other hand, neither sex nor clinical presentation, family background, positive histology or HLA status were associated with DY. CE results changed the therapeutic approach in 71.8% of the cases. Atrophy was associated with a greater TI (92.3% vs 45.3%, P < 0.001) and 81.9% of the patients responded to diet. There was one case of capsule retention (0.6%). Agreement between CE findings and subsequent histology was 100% for diagnosing normal/other conditions, 70% for suspected CD and 50% for complicated CD. CONCLUSION: CE has a high DY in cases of suspicion of CD and it leads to changes in the clinical course of the disease. CE is safe procedure with a high degree of concordance with histology and it helps in the differential diagnosis of CD.
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spelling pubmed-52923452017-02-17 Role of capsule endoscopy in suspected celiac disease: A European multi-centre study Luján-Sanchis, Marisol Pérez-Cuadrado-Robles, Enrique García-Lledó, Javier Juanmartiñena Fernández, José-Francisco Elli, Luca Jiménez-García, Victoria-Alejandra Egea-Valenzuela, Juan Valle-Muñoz, Julio Carretero-Ribón, Cristina Fernández-Urién-Sainz, Ignacio López-Higueras, Antonio Alonso-Lázaro, Noelia Sanjuan-Acosta, Mileidis Sánchez-Ceballos, Francisco Rosa, Bruno González-Vázquez, Santiago Branchi, Federica Ruano-Díaz, Lucía Prieto-de-Frías, César Pons-Beltrán, Vicente Borque-Barrera, Pilar González-Suárez, Begoña Xavier, Sofía Argüelles-Arias, Federico Herrerías-Gutiérrez, Juan-Manuel Pérez-Cuadrado-Martínez, Enrique Sempere-García-Argüelles, Javier World J Gastroenterol Observational Study AIM: To analyze the diagnostic yield (DY), therapeutic impact (TI) and safety of capsule endoscopy (CE). METHODS: This is a multi-centre, observational, analytical, retrospective study. A total of 163 patients with suspicion of celiac disease (CD) (mean age = 46.4 ± 17.3 years, 68.1% women) who underwent CE from 2003 to 2015 were included. Patients were divided into four groups: seronegative CD with atrophy (Group-I, n = 19), seropositive CD without atrophy (Group-II, n = 39), contraindication to gastroscopy (Group-III, n = 6), seronegative CD without atrophy, but with a compatible context (Group-IV, n = 99). DY, TI and the safety of CE were analysed. RESULTS: The overall DY was 54% and the final diagnosis was villous atrophy (n = 65, 39.9%), complicated CD (n = 12, 7.4%) and other enteropathies (n = 11, 6.8%; 8 Crohn’s). DY for groups I to IV was 73.7%, 69.2%, 50% and 44.4%, respectively. Atrophy was located in duodenum in 24 cases (36.9%), diffuse in 19 (29.2%), jejunal in 11 (16.9%), and patchy in 10 cases (15.4%). Factors associated with a greater DY were positive serology (68.3% vs 49.2%, P = 0.034) and older age (P = 0.008). On the other hand, neither sex nor clinical presentation, family background, positive histology or HLA status were associated with DY. CE results changed the therapeutic approach in 71.8% of the cases. Atrophy was associated with a greater TI (92.3% vs 45.3%, P < 0.001) and 81.9% of the patients responded to diet. There was one case of capsule retention (0.6%). Agreement between CE findings and subsequent histology was 100% for diagnosing normal/other conditions, 70% for suspected CD and 50% for complicated CD. CONCLUSION: CE has a high DY in cases of suspicion of CD and it leads to changes in the clinical course of the disease. CE is safe procedure with a high degree of concordance with histology and it helps in the differential diagnosis of CD. Baishideng Publishing Group Inc 2017-01-28 2017-01-28 /pmc/articles/PMC5292345/ /pubmed/28216978 http://dx.doi.org/10.3748/wjg.v23.i4.703 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 Observational Study
Luján-Sanchis, Marisol
Pérez-Cuadrado-Robles, Enrique
García-Lledó, Javier
Juanmartiñena Fernández, José-Francisco
Elli, Luca
Jiménez-García, Victoria-Alejandra
Egea-Valenzuela, Juan
Valle-Muñoz, Julio
Carretero-Ribón, Cristina
Fernández-Urién-Sainz, Ignacio
López-Higueras, Antonio
Alonso-Lázaro, Noelia
Sanjuan-Acosta, Mileidis
Sánchez-Ceballos, Francisco
Rosa, Bruno
González-Vázquez, Santiago
Branchi, Federica
Ruano-Díaz, Lucía
Prieto-de-Frías, César
Pons-Beltrán, Vicente
Borque-Barrera, Pilar
González-Suárez, Begoña
Xavier, Sofía
Argüelles-Arias, Federico
Herrerías-Gutiérrez, Juan-Manuel
Pérez-Cuadrado-Martínez, Enrique
Sempere-García-Argüelles, Javier
Role of capsule endoscopy in suspected celiac disease: A European multi-centre study
title Role of capsule endoscopy in suspected celiac disease: A European multi-centre study
title_full Role of capsule endoscopy in suspected celiac disease: A European multi-centre study
title_fullStr Role of capsule endoscopy in suspected celiac disease: A European multi-centre study
title_full_unstemmed Role of capsule endoscopy in suspected celiac disease: A European multi-centre study
title_short Role of capsule endoscopy in suspected celiac disease: A European multi-centre study
title_sort role of capsule endoscopy in suspected celiac disease: a european multi-centre study
topic Observational Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5292345/
https://www.ncbi.nlm.nih.gov/pubmed/28216978
http://dx.doi.org/10.3748/wjg.v23.i4.703
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