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Role of magnified ileoscopy in the diagnosis of cases of coeliac disease with predominant abdominal symptoms.
Scand J Gastroenterol. 2009; 44(3):320-4.SJ

Abstract

OBJECTIVE

Less severe histological changes have sometimes been reported in the terminal ileum (TI) of coeliac patients. The aim of this work was to assess whether magnified ileoscopy and the corresponding biopsy could be used when diagnosing coeliac disease (CD). This would be of clinical value in coeliac patients who show predominant abdominal symptoms and who undergo colonoscopy with ileoscopy as first clinical examination.

MATERIAL AND METHODS

All patients underwent conventional and magnified ileoscopy, along with histological examination of macroscopic mucosal abnormalities, if present. Patients whose ileoscopy with biopsy suggested CD underwent a blood test for quantitative determination of anti-transglutaminase antibodies and upper gastrointestinal endoscopy with corresponding duodenal biopsy.

RESULTS

Out of 143 patients enrolled, 21 had a TI mucosal lesion, and 10 of these showed villous atrophy at ileoscopy only after magnification. Six showed a count of intra-epithelial lymphocytes (IELs) >25/100 enterocytes and upper intestinal lesions, confirming the diagnosis of CD. Finally, of four patients diagnosed with Crohn's disease, TI mucosal aftoid lesions were seen in two only in magnified view.

CONCLUSIONS

Magnified ileoscopy reliably recognizes the presence of mucosal villous subtotal or total atrophy at TI. This finding, even if not specific to CD, can address the diagnosis of CD. Magnification in the course of ileoscopy could also be useful in the diagnosis of Crohn's disease.

Authors+Show Affiliations

Division of Operative Endoscopy and Gastroenterology, Fabio Di Giovambattista - USI, Rome, Italy. arimecme@tin.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18991166

Citation

Trecca, Antonello, et al. "Role of Magnified Ileoscopy in the Diagnosis of Cases of Coeliac Disease With Predominant Abdominal Symptoms." Scandinavian Journal of Gastroenterology, vol. 44, no. 3, 2009, pp. 320-4.
Trecca A, Gaj F, Gagliardi G, et al. Role of magnified ileoscopy in the diagnosis of cases of coeliac disease with predominant abdominal symptoms. Scand J Gastroenterol. 2009;44(3):320-4.
Trecca, A., Gaj, F., Gagliardi, G., Calcaterra, R., Battista, S., & Silano, M. (2009). Role of magnified ileoscopy in the diagnosis of cases of coeliac disease with predominant abdominal symptoms. Scandinavian Journal of Gastroenterology, 44(3), 320-4. https://doi.org/10.1080/00365520802538237
Trecca A, et al. Role of Magnified Ileoscopy in the Diagnosis of Cases of Coeliac Disease With Predominant Abdominal Symptoms. Scand J Gastroenterol. 2009;44(3):320-4. PubMed PMID: 18991166.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Role of magnified ileoscopy in the diagnosis of cases of coeliac disease with predominant abdominal symptoms. AU - Trecca,Antonello, AU - Gaj,Fabio, AU - Gagliardi,Giuseppe, AU - Calcaterra,Roberta, AU - Battista,Serena, AU - Silano,Marco, PY - 2008/11/11/pubmed PY - 2009/5/6/medline PY - 2008/11/11/entrez SP - 320 EP - 4 JF - Scandinavian journal of gastroenterology JO - Scand J Gastroenterol VL - 44 IS - 3 N2 - OBJECTIVE: Less severe histological changes have sometimes been reported in the terminal ileum (TI) of coeliac patients. The aim of this work was to assess whether magnified ileoscopy and the corresponding biopsy could be used when diagnosing coeliac disease (CD). This would be of clinical value in coeliac patients who show predominant abdominal symptoms and who undergo colonoscopy with ileoscopy as first clinical examination. MATERIAL AND METHODS: All patients underwent conventional and magnified ileoscopy, along with histological examination of macroscopic mucosal abnormalities, if present. Patients whose ileoscopy with biopsy suggested CD underwent a blood test for quantitative determination of anti-transglutaminase antibodies and upper gastrointestinal endoscopy with corresponding duodenal biopsy. RESULTS: Out of 143 patients enrolled, 21 had a TI mucosal lesion, and 10 of these showed villous atrophy at ileoscopy only after magnification. Six showed a count of intra-epithelial lymphocytes (IELs) >25/100 enterocytes and upper intestinal lesions, confirming the diagnosis of CD. Finally, of four patients diagnosed with Crohn's disease, TI mucosal aftoid lesions were seen in two only in magnified view. CONCLUSIONS: Magnified ileoscopy reliably recognizes the presence of mucosal villous subtotal or total atrophy at TI. This finding, even if not specific to CD, can address the diagnosis of CD. Magnification in the course of ileoscopy could also be useful in the diagnosis of Crohn's disease. SN - 1502-7708 UR - https://www.unboundmedicine.com/medline/citation/18991166/Role_of_magnified_ileoscopy_in_the_diagnosis_of_cases_of_coeliac_disease_with_predominant_abdominal_symptoms_ L2 - https://www.tandfonline.com/doi/full/10.1080/00365520802538237 DB - PRIME DP - Unbound Medicine ER -