Marisol Luján-Sanchis, Javier Sempere-García-Argüelles, Digestive Diseases Unit, General University Hospital of Valencia, 46026 Valencia, Spain.
Enrique Pérez-Cuadrado-Robles, Antonio López-Higueras, Enrique Pérez-Cuadrado-Martínez, Small Bowel Unit, Hospital Morales Meseguer, 30008 Murcia, Spain.
Javier García-Lledó, Digestive Diseases Unit, General University Gregorio Marañón, 28007 Madrid, Spain.
José-Francisco Juanmartiñena Fernández, Ignacio Fernández-Urién-Sainz, Unit of Gastroenterology and Endoscopy, Complejo Hospitalario de Navarra, 31008 Pamplona, Spain.
Luca Elli, Federica Branchi, Center for prevention and Diagnosis of Celiac Disease, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
Victoria-Alejandra Jiménez-García, Federico Argüelles-Arias, Juan-Manuel Herrerías-Gutiérrez, Unit of Gastroenterology and Endoscopy, University Hospital Virgen Macarena, 41071 Sevilla, Spain.
Juan Egea-Valenzuela, Gastroenterology department, Hospital Virgen de la Arrixaca, 30120 Murcia, Spain.
Julio Valle-Muñoz, Lucía Ruano-Díaz, Department of Gastroenterology, Complejo Hospitalario de Toledo, 45005 Toledo, Spain.
Cristina Carretero-Ribón, Santiago González-Vázquez, César Prieto-de-Frías, Department of Gastroenterology, University of Navarra Clinic, 31009 Pamplona, Spain.
Noelia Alonso-Lázaro, Vicente Pons-Beltrán, Endoscopy Digestive Unit, Digestive Diseases Area, Universitari i Politècnic La Fe Hospital, 46026 Valencia, Spain.
Mileidis Sanjuan-Acosta, Pilar Borque-Barrera, Digestive Diseases Unit, University Hospital Nuestra Señora de Candelaria, 38010 Tenerife, Spain.
Francisco Sánchez-Ceballos, Digestive Diseases Unit, Clinical Hospital San Carlos, 28040 Madrid, Spain.
Bruno Rosa, Sofía Xavier, Digestive Diseases Unit, Hospital da Senhora da Oliveira - Guimarães, 114 Cutileiros, Portugal.
Begoña González-Suárez, Endoscopy Digestive Unit, Hospital Clinic de Barcelona, 08036 Barcelona, Spain.
ABSTRACT
AIM
To analyze the diagnostic yield (DY), therapeutic impact (TI) and safety of capsule endoscopy (CE).
METHODS
This is a multi-centre, observational, analytical, retrospective study. A total of 163 patients with suspicion of celiac disease (CD) (mean age = 46.4 ± 17.3 years, 68.1% women) who underwent CE from 2003 to 2015 were included. Patients were divided into four groups: seronegative CD with atrophy (Group-I, n = 19), seropositive CD without atrophy (Group-II, n = 39), contraindication to gastroscopy (Group-III, n = 6), seronegative CD without atrophy, but with a compatible context (Group-IV, n = 99). DY, TI and the safety of CE were analysed.
RESULTS
The overall DY was 54% and the final diagnosis was villous atrophy (n = 65, 39.9%), complicated CD (n = 12, 7.4%) and other enteropathies (n = 11, 6.8%; 8 Crohn’s). DY for groups I to IV was 73.7%, 69.2%, 50% and 44.4%, respectively. Atrophy was located in duodenum in 24 cases (36.9%), diffuse in 19 (29.2%), jejunal in 11 (16.9%), and patchy in 10 cases (15.4%). Factors associated with a greater DY were positive serology (68.3% vs 49.2%, P = 0.034) and older age (P = 0.008). On the other hand, neither sex nor clinical presentation, family background, positive histology or HLA status were associated with DY. CE results changed the therapeutic approach in 71.8% of the cases. Atrophy was associated with a greater TI (92.3% vs 45.3%, P < 0.001) and 81.9% of the patients responded to diet. There was one case of capsule retention (0.6%). Agreement between CE findings and subsequent histology was 100% for diagnosing normal/other conditions, 70% for suspected CD and 50% for complicated CD.
CONCLUSION
CE has a high DY in cases of suspicion of CD and it leads to changes in the clinical course of the disease. CE is safe procedure with a high degree of concordance with histology and it helps in the differential diagnosis of CD.
