Tags

Type your tag names separated by a space and hit enter

Newly detected celiac disease by wireless capsule endoscopy in older adults with iron deficiency anemia.
J Clin Gastroenterol. 2008 Oct; 42(9):980-3.JC

Abstract

BACKGROUND

The prevalence of celiac disease (CD) is estimated to be 1% in the US population, yet many cases are undiagnosed. CD might present itself in the older adults (age >60 y) for the first time, solely with iron deficiency anemia (IDA). Recent studies indicate that approximately 20% of newly diagnosed CD patients are older than 60 years. Wireless capsule endoscopy (WCE) identifies small bowel mucosal abnormalities by direct visualization. Incidental findings observed by WCE indicative of CD prompt confirmatory diagnostic tests such as IgA class antitissue transglutaminase antibody and IgA class antiendomysial antibody.

AIM

To present the frequency of mucosal abnormalities and their location suggestive of CD observed by WCE, in the older adults with IDA.

MATERIALS AND METHODS

In this retrospective study, data is collected from patients who underwent WCE mostly for the evaluation of IDA with or without other symptoms such as obscure gastrointestinal bleeding, abdominal pain, and chronic diarrhea over a period of 5 years (2002 to 2007).

RESULTS

Out of 652 cases of WCE, 360 were older adults (age >60 y). Evaluation of IDA was the indication in 279 out of 360 (78%) older adults. Among the 279 older adults with IDA, 7 (2.5%) had mucosal abnormalities suggestive of CD (atrophy, scalloping, mosaicism, layering, and nonspecific ulcerating jejuno-ileitis). Subsequent evaluation with serum antibody testing +/-multiple distal duodenal biopsies confirmed the diagnosis in all patients. Five out of 7 (71%) older adults had normal looking duodenal mucosa on WCE, but had classic abnormalities of CD distally.

CONCLUSIONS

(1) Mucosal abnormalities of CD may be seen on WCE for the first time, in the older adults with IDA with no past clinical picture of the disease. (2) Duodenum may be entirely normal by esophagogastroduodenoscopy examination; whereas the proximal and distal intestine may show classic features of CD by WCE.

Authors+Show Affiliations

Division of Hospital Medicine, Saint Peter's University Hospital, New Brunswick, NJ, USA. adnan_muhd@hotmail.comNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18596537

Citation

Muhammad, Adnan, and C S. Pitchumoni. "Newly Detected Celiac Disease By Wireless Capsule Endoscopy in Older Adults With Iron Deficiency Anemia." Journal of Clinical Gastroenterology, vol. 42, no. 9, 2008, pp. 980-3.
Muhammad A, Pitchumoni CS. Newly detected celiac disease by wireless capsule endoscopy in older adults with iron deficiency anemia. J Clin Gastroenterol. 2008;42(9):980-3.
Muhammad, A., & Pitchumoni, C. S. (2008). Newly detected celiac disease by wireless capsule endoscopy in older adults with iron deficiency anemia. Journal of Clinical Gastroenterology, 42(9), 980-3. https://doi.org/10.1097/MCG.0b013e3181354455
Muhammad A, Pitchumoni CS. Newly Detected Celiac Disease By Wireless Capsule Endoscopy in Older Adults With Iron Deficiency Anemia. J Clin Gastroenterol. 2008;42(9):980-3. PubMed PMID: 18596537.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Newly detected celiac disease by wireless capsule endoscopy in older adults with iron deficiency anemia. AU - Muhammad,Adnan, AU - Pitchumoni,C S, PY - 2008/7/4/pubmed PY - 2008/12/17/medline PY - 2008/7/4/entrez SP - 980 EP - 3 JF - Journal of clinical gastroenterology JO - J Clin Gastroenterol VL - 42 IS - 9 N2 - BACKGROUND: The prevalence of celiac disease (CD) is estimated to be 1% in the US population, yet many cases are undiagnosed. CD might present itself in the older adults (age >60 y) for the first time, solely with iron deficiency anemia (IDA). Recent studies indicate that approximately 20% of newly diagnosed CD patients are older than 60 years. Wireless capsule endoscopy (WCE) identifies small bowel mucosal abnormalities by direct visualization. Incidental findings observed by WCE indicative of CD prompt confirmatory diagnostic tests such as IgA class antitissue transglutaminase antibody and IgA class antiendomysial antibody. AIM: To present the frequency of mucosal abnormalities and their location suggestive of CD observed by WCE, in the older adults with IDA. MATERIALS AND METHODS: In this retrospective study, data is collected from patients who underwent WCE mostly for the evaluation of IDA with or without other symptoms such as obscure gastrointestinal bleeding, abdominal pain, and chronic diarrhea over a period of 5 years (2002 to 2007). RESULTS: Out of 652 cases of WCE, 360 were older adults (age >60 y). Evaluation of IDA was the indication in 279 out of 360 (78%) older adults. Among the 279 older adults with IDA, 7 (2.5%) had mucosal abnormalities suggestive of CD (atrophy, scalloping, mosaicism, layering, and nonspecific ulcerating jejuno-ileitis). Subsequent evaluation with serum antibody testing +/-multiple distal duodenal biopsies confirmed the diagnosis in all patients. Five out of 7 (71%) older adults had normal looking duodenal mucosa on WCE, but had classic abnormalities of CD distally. CONCLUSIONS: (1) Mucosal abnormalities of CD may be seen on WCE for the first time, in the older adults with IDA with no past clinical picture of the disease. (2) Duodenum may be entirely normal by esophagogastroduodenoscopy examination; whereas the proximal and distal intestine may show classic features of CD by WCE. SN - 1539-2031 UR - https://www.unboundmedicine.com/medline/citation/18596537/Newly_detected_celiac_disease_by_wireless_capsule_endoscopy_in_older_adults_with_iron_deficiency_anemia_ L2 - https://doi.org/10.1097/MCG.0b013e3181354455 DB - PRIME DP - Unbound Medicine ER -