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A highly accurate method for monitoring histological recovery in patients with celiac disease on a gluten-free diet using an endoscopic approach that avoids the need for biopsy: a double-center study.
Endoscopy. 2007 Jan; 39(1):46-51.E

Abstract

BACKGROUND AND STUDY AIM

Endoscopy with duodenal biopsy is often performed in order to assess histological recovery in patients with celiac disease who are on a gluten-free diet. Use of the "immersion" technique during upper endoscopy allows visualization of duodenal villi or detection of total villous atrophy. In this two-center study, we investigated the accuracy of the immersion technique in predicting histological recovery in patients on a gluten-free diet whose initial diagnosis of celiac disease had been made on the basis of total villous atrophy.

PATIENTS AND METHODS

The immersion technique was performed in 62 patients with celiac disease who were being treated and who had been referred for follow-up (26 patients at the Rome center and 36 patients at the Vicenza center). All these patients had an initial diagnosis based on positive antibodies and biopsy-proved duodenal total villous atrophy. At the follow-up examination, the duodenal villi were re-evaluated as present or absent by one endoscopist at each center, and the results were compared with the histology.

RESULTS

At the follow-up endoscopy, the duodenal villi were found to be present in 51 patients and absent in 11. The sensitivity, specificity, positive predictive value, and negative predictive value of the immersion technique for detecting the presence or absence of villi were all 100 %.

CONCLUSIONS

This study demonstrated the feasibility and the high level of accuracy of the immersion technique in predicting the histological recovery of duodenal villi in patients with celiac disease who are following a gluten-free diet. An endoscopy-based approach that avoids the need for biopsy could be useful for monitoring the dietary adherence and/or response of patients with an initial diagnosis of celiac disease based on total villous atrophy.

Authors+Show Affiliations

Department of Internal Medicine and Gastroenterology, Catholic University of Medicine and Surgery, Rome, Italy. gcammarota.@rm.unicatt.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

17252460

Citation

Cammarota, G, et al. "A Highly Accurate Method for Monitoring Histological Recovery in Patients With Celiac Disease On a Gluten-free Diet Using an Endoscopic Approach That Avoids the Need for Biopsy: a Double-center Study." Endoscopy, vol. 39, no. 1, 2007, pp. 46-51.
Cammarota G, Cuoco L, Cesaro P, et al. A highly accurate method for monitoring histological recovery in patients with celiac disease on a gluten-free diet using an endoscopic approach that avoids the need for biopsy: a double-center study. Endoscopy. 2007;39(1):46-51.
Cammarota, G., Cuoco, L., Cesaro, P., Santoro, L., Cazzato, A., Montalto, M., La Mura, R., Larocca, L. M., Vecchio, F. M., Gasbarrini, A., Salvagnini, M., & Gasbarrini, G. (2007). A highly accurate method for monitoring histological recovery in patients with celiac disease on a gluten-free diet using an endoscopic approach that avoids the need for biopsy: a double-center study. Endoscopy, 39(1), 46-51.
Cammarota G, et al. A Highly Accurate Method for Monitoring Histological Recovery in Patients With Celiac Disease On a Gluten-free Diet Using an Endoscopic Approach That Avoids the Need for Biopsy: a Double-center Study. Endoscopy. 2007;39(1):46-51. PubMed PMID: 17252460.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A highly accurate method for monitoring histological recovery in patients with celiac disease on a gluten-free diet using an endoscopic approach that avoids the need for biopsy: a double-center study. AU - Cammarota,G, AU - Cuoco,L, AU - Cesaro,P, AU - Santoro,L, AU - Cazzato,A, AU - Montalto,M, AU - La Mura,R, AU - Larocca,L M, AU - Vecchio,F M, AU - Gasbarrini,A, AU - Salvagnini,M, AU - Gasbarrini,G, PY - 2007/1/26/pubmed PY - 2007/3/10/medline PY - 2007/1/26/entrez SP - 46 EP - 51 JF - Endoscopy JO - Endoscopy VL - 39 IS - 1 N2 - BACKGROUND AND STUDY AIM: Endoscopy with duodenal biopsy is often performed in order to assess histological recovery in patients with celiac disease who are on a gluten-free diet. Use of the "immersion" technique during upper endoscopy allows visualization of duodenal villi or detection of total villous atrophy. In this two-center study, we investigated the accuracy of the immersion technique in predicting histological recovery in patients on a gluten-free diet whose initial diagnosis of celiac disease had been made on the basis of total villous atrophy. PATIENTS AND METHODS: The immersion technique was performed in 62 patients with celiac disease who were being treated and who had been referred for follow-up (26 patients at the Rome center and 36 patients at the Vicenza center). All these patients had an initial diagnosis based on positive antibodies and biopsy-proved duodenal total villous atrophy. At the follow-up examination, the duodenal villi were re-evaluated as present or absent by one endoscopist at each center, and the results were compared with the histology. RESULTS: At the follow-up endoscopy, the duodenal villi were found to be present in 51 patients and absent in 11. The sensitivity, specificity, positive predictive value, and negative predictive value of the immersion technique for detecting the presence or absence of villi were all 100 %. CONCLUSIONS: This study demonstrated the feasibility and the high level of accuracy of the immersion technique in predicting the histological recovery of duodenal villi in patients with celiac disease who are following a gluten-free diet. An endoscopy-based approach that avoids the need for biopsy could be useful for monitoring the dietary adherence and/or response of patients with an initial diagnosis of celiac disease based on total villous atrophy. SN - 0013-726X UR - https://www.unboundmedicine.com/medline/citation/17252460/A_highly_accurate_method_for_monitoring_histological_recovery_in_patients_with_celiac_disease_on_a_gluten_free_diet_using_an_endoscopic_approach_that_avoids_the_need_for_biopsy:_a_double_center_study_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-2006-945044 DB - PRIME DP - Unbound Medicine ER -