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The use of small-bowel capsule endoscopy in iron-deficiency anemia alone; be aware of the young anemic patient.
Scand J Gastroenterol. 2012 Sep; 47(8-9):1094-100.SJ

Abstract

BACKGROUND & AIM

The role of Small-Bowel Capsule Endoscopy (SBCE) in Iron Deficiency Anemia (IDA) alone is still under validation. We aim to assess the usefulness of SBCE in patients with IDA alone.

METHODS

Retrospective study; patients with IDA (no GI symptoms or known previous diagnosis), who underwent SBCE were included. SBCE findings were classified as clinically significant/sinister (small-bowel malignancy, significant/sinister inflammation and/or strictures and coeliac disease) or vascular, i.e., signifcant/angioectasias (P1/P2 lesions).

RESULTS

A total of 221 (151F/70M) patients had SBCE for IDA as the sole indication. The diagnostic yield (DY) was 30.7% (68/221). The DY for significant/sinister pathology and significant/angioectasias was 9% and 21.7%, respectively. In those ≤ 40 years (20; 13F/7M), significant pathology was found in 25% (5/20); in the >40-year group (201; 138F/63M), significant/sinister pathology was found in 7.5% (15/201), p = 0.0231. None of the patients ≤40 years had angioectasias, such lesions were found in 48/201 (21.7%) of those >40 years, p = 0.009. Fifty percent of those >80 years (16; 12F/4M) had angioectasias, but none had significant/sinister pathology (p = 0.0126). On multiple regression analysis, only prior blood transfusion was predictive of higher DY in SBCE.

CONCLUSIONS

IDA alone is one of the main indications (27%) for referral to SBCE; the majority of patients are >40 years. In our cohort, the DY of SBCE for IDA was 30.7% and the commonest finding was angioectasias. The detection rate of sinister small-bowel pathology for those >40 years is low decreasing to zero in the >80 age group. In contrast, 25% of those ≤40 years had a sinister diagnosis.

Authors+Show Affiliations

Centre for Liver & Digestive Disorders, The Royal Infirmary of Edinburgh, Edinburgh, UK. akoulaouzidis@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22852553

Citation

Koulaouzidis, Anastasios, et al. "The Use of Small-bowel Capsule Endoscopy in Iron-deficiency Anemia Alone; Be Aware of the Young Anemic Patient." Scandinavian Journal of Gastroenterology, vol. 47, no. 8-9, 2012, pp. 1094-100.
Koulaouzidis A, Yung DE, Lam JH, et al. The use of small-bowel capsule endoscopy in iron-deficiency anemia alone; be aware of the young anemic patient. Scand J Gastroenterol. 2012;47(8-9):1094-100.
Koulaouzidis, A., Yung, D. E., Lam, J. H., Smirnidis, A., Douglas, S., & Plevris, J. N. (2012). The use of small-bowel capsule endoscopy in iron-deficiency anemia alone; be aware of the young anemic patient. Scandinavian Journal of Gastroenterology, 47(8-9), 1094-100. https://doi.org/10.3109/00365521.2012.704938
Koulaouzidis A, et al. The Use of Small-bowel Capsule Endoscopy in Iron-deficiency Anemia Alone; Be Aware of the Young Anemic Patient. Scand J Gastroenterol. 2012;47(8-9):1094-100. PubMed PMID: 22852553.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The use of small-bowel capsule endoscopy in iron-deficiency anemia alone; be aware of the young anemic patient. AU - Koulaouzidis,Anastasios, AU - Yung,Diana E, AU - Lam,Jeff H P, AU - Smirnidis,Alexandros, AU - Douglas,Sarah, AU - Plevris,John N, Y1 - 2012/08/02/ PY - 2012/8/3/entrez PY - 2012/8/3/pubmed PY - 2013/3/23/medline SP - 1094 EP - 100 JF - Scandinavian journal of gastroenterology JO - Scand J Gastroenterol VL - 47 IS - 8-9 N2 - BACKGROUND & AIM: The role of Small-Bowel Capsule Endoscopy (SBCE) in Iron Deficiency Anemia (IDA) alone is still under validation. We aim to assess the usefulness of SBCE in patients with IDA alone. METHODS: Retrospective study; patients with IDA (no GI symptoms or known previous diagnosis), who underwent SBCE were included. SBCE findings were classified as clinically significant/sinister (small-bowel malignancy, significant/sinister inflammation and/or strictures and coeliac disease) or vascular, i.e., signifcant/angioectasias (P1/P2 lesions). RESULTS: A total of 221 (151F/70M) patients had SBCE for IDA as the sole indication. The diagnostic yield (DY) was 30.7% (68/221). The DY for significant/sinister pathology and significant/angioectasias was 9% and 21.7%, respectively. In those ≤ 40 years (20; 13F/7M), significant pathology was found in 25% (5/20); in the >40-year group (201; 138F/63M), significant/sinister pathology was found in 7.5% (15/201), p = 0.0231. None of the patients ≤40 years had angioectasias, such lesions were found in 48/201 (21.7%) of those >40 years, p = 0.009. Fifty percent of those >80 years (16; 12F/4M) had angioectasias, but none had significant/sinister pathology (p = 0.0126). On multiple regression analysis, only prior blood transfusion was predictive of higher DY in SBCE. CONCLUSIONS: IDA alone is one of the main indications (27%) for referral to SBCE; the majority of patients are >40 years. In our cohort, the DY of SBCE for IDA was 30.7% and the commonest finding was angioectasias. The detection rate of sinister small-bowel pathology for those >40 years is low decreasing to zero in the >80 age group. In contrast, 25% of those ≤40 years had a sinister diagnosis. SN - 1502-7708 UR - https://www.unboundmedicine.com/medline/citation/22852553/The_use_of_small_bowel_capsule_endoscopy_in_iron_deficiency_anemia_alone L2 - https://www.tandfonline.com/doi/full/10.3109/00365521.2012.704938 DB - PRIME DP - Unbound Medicine ER -