Tags

Type your tag names separated by a space and hit enter

Capsule endoscopy: an alternative to duodenal biopsy for the recognition of villous atrophy in coeliac disease?
Dig Liver Dis. 2007 Feb; 39(2):140-5.DL

Abstract

BACKGROUND

Villous atrophy present on a duodenal biopsy remains the 'gold standard' diagnostic test for coeliac disease. However, endoscopic biopsy may cause morbidity and discomfort. Our aim was to evaluate wireless capsule endoscopy as an alternative test for the recognition of villous atrophy.

METHOD

Twenty-one patients with a positive endomysial antibody referred for endoscopy and duodenal biopsy were also offered a wireless capsule endoscopy to evaluate their small bowel. Concurrently, other patients (n=23) referred for a wireless capsule endoscopy acted as controls. Wireless capsule endoscopy reports were assessed for the presence of villous atrophy by one blinded investigator.

RESULTS

Twenty endomysial antibody positive patients subsequently had villous atrophy on duodenal biopsy. The controls all had normal duodenal biopsies (with a negative endomysial antibody) and no evidence of villous atrophy noted on their wireless capsule endoscopy. Of the 20 endomysial antibody positive patients with confirmed villous atrophy on biopsy, 17 had villous atrophy also detected by wireless capsule endoscopy. The sensitivity, specificity, positive and negative predictive values for wireless capsule endoscopy recognising villous atrophy were 85%, 100%, 100%, 88.9%, respectively.

CONCLUSION

Wireless capsule endoscopy may be an option to recognise villous atrophy in patients with a positive endomysial antibody who are unwilling, or unable to have a gastroscopy. However, a negative test should be followed by a biopsy if coeliac disease is to be excluded.

Authors+Show Affiliations

Department of Gastroenterology, Royal Hallamshire Hospital, Sheffield, UK. andydhopper@aol.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article
Validation Study

Language

eng

PubMed ID

16965945

Citation

Hopper, A D., et al. "Capsule Endoscopy: an Alternative to Duodenal Biopsy for the Recognition of Villous Atrophy in Coeliac Disease?" Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, vol. 39, no. 2, 2007, pp. 140-5.
Hopper AD, Sidhu R, Hurlstone DP, et al. Capsule endoscopy: an alternative to duodenal biopsy for the recognition of villous atrophy in coeliac disease? Dig Liver Dis. 2007;39(2):140-5.
Hopper, A. D., Sidhu, R., Hurlstone, D. P., McAlindon, M. E., & Sanders, D. S. (2007). Capsule endoscopy: an alternative to duodenal biopsy for the recognition of villous atrophy in coeliac disease? Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, 39(2), 140-5.
Hopper AD, et al. Capsule Endoscopy: an Alternative to Duodenal Biopsy for the Recognition of Villous Atrophy in Coeliac Disease. Dig Liver Dis. 2007;39(2):140-5. PubMed PMID: 16965945.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Capsule endoscopy: an alternative to duodenal biopsy for the recognition of villous atrophy in coeliac disease? AU - Hopper,A D, AU - Sidhu,R, AU - Hurlstone,D P, AU - McAlindon,M E, AU - Sanders,D S, Y1 - 2006/09/11/ PY - 2006/06/05/received PY - 2006/07/22/revised PY - 2006/07/27/accepted PY - 2006/9/13/pubmed PY - 2007/4/5/medline PY - 2006/9/13/entrez SP - 140 EP - 5 JF - Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver JO - Dig Liver Dis VL - 39 IS - 2 N2 - BACKGROUND: Villous atrophy present on a duodenal biopsy remains the 'gold standard' diagnostic test for coeliac disease. However, endoscopic biopsy may cause morbidity and discomfort. Our aim was to evaluate wireless capsule endoscopy as an alternative test for the recognition of villous atrophy. METHOD: Twenty-one patients with a positive endomysial antibody referred for endoscopy and duodenal biopsy were also offered a wireless capsule endoscopy to evaluate their small bowel. Concurrently, other patients (n=23) referred for a wireless capsule endoscopy acted as controls. Wireless capsule endoscopy reports were assessed for the presence of villous atrophy by one blinded investigator. RESULTS: Twenty endomysial antibody positive patients subsequently had villous atrophy on duodenal biopsy. The controls all had normal duodenal biopsies (with a negative endomysial antibody) and no evidence of villous atrophy noted on their wireless capsule endoscopy. Of the 20 endomysial antibody positive patients with confirmed villous atrophy on biopsy, 17 had villous atrophy also detected by wireless capsule endoscopy. The sensitivity, specificity, positive and negative predictive values for wireless capsule endoscopy recognising villous atrophy were 85%, 100%, 100%, 88.9%, respectively. CONCLUSION: Wireless capsule endoscopy may be an option to recognise villous atrophy in patients with a positive endomysial antibody who are unwilling, or unable to have a gastroscopy. However, a negative test should be followed by a biopsy if coeliac disease is to be excluded. SN - 1590-8658 UR - https://www.unboundmedicine.com/medline/citation/16965945/Capsule_endoscopy:_an_alternative_to_duodenal_biopsy_for_the_recognition_of_villous_atrophy_in_coeliac_disease L2 - https://linkinghub.elsevier.com/retrieve/pii/S1590-8658(06)00336-7 DB - PRIME DP - Unbound Medicine ER -