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Role of capsule endoscopy in alarm features and non-responsive celiac disease: A European multicenter study

15 Fev. 2019 |

Perez-Cuadrado-Robles E1Lujan-Sanchis M2, Elli L3Juanmartinena-Fernandez JF4Garcıa-Lledo J5Ruano-Dıaz L6Egea-Valenzuela J7Jimenez-Garcıa VA8Arguelles-Arias F8Juan-Acosta MS9Carretero-Ribon C10Alonso-Lazaro N11Rosa B12Sanchez-Ceballos F13Lopez-Higueras A2Fernandez-Urien-Sainz I4Branchi F3Valle-Muñoz J6Borque-Barrera P9Gonzalez-Vazquez S10Pons-Beltran V11, Xavier S12Gonzalez-Suarez B14Herrerıas-Gutierrez JM8Perez-Cuadrado-Martınez E2Sempere-Garcıa-Arguelles J1Enteroscopy and Capsule Endoscopy Spanish Society Group of the Spanish Society of Digestive Endoscopy (SEED)

1Small Bowel Unit, Morales Meseguer Hospital, Murcia, Spain.

2Digestive Diseases Unit, General University Hospital of Valencia, Valencia, Spain.

3Center for Prevention and Diagnosis of Celiac Disease, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy.

4Gastroenterology and Endoscopy Unit, Navarra Hospital, Pamplona, Spain.

5Digestive Diseases Unit, General University Hospital Gregorio Marañon, Madrid, Spain.

6Department of Gastroenterology, Toledo Hospital, Toledo, Spain.

7Department of Gastroenterology, University Hospital Virgen de la Arrixaca, Murcia, Spain.

8Gastroenterology and Endoscopy Unit, University Hospital Virgen Macarena, Sevilla, Spain.

9Digestive Diseases Unit, University Hospital Nuestra Señora de Candelaria, Tenerife, Spain.

10Department of Gastroenterology, University of Navarra Clinic, Pamplona, Spain.

11Endoscopy Digestive Unit, Digestive Diseases Unit, University Hospital La Fe, Valencia, Spain.

12Digestive Diseases Unit, Senhora da Oliveira Hospital, Guimaraes, Portugal.

13Digestive Diseases Unit, San Carlos Hospital, Madrid, Spain.

14Endoscopy Digestive Unit Hospital Clinic of Barcelona, Barcelona, Spain.

ABSTRACT

Background and aim:

The role of capsule endoscopy (CE) in established celiac disease (CD) remains unclear. Our objective was to analyze the usefulness of CE in the suspicion of complicated CD.

Methods:

This was a retrospective multicenter study. One hundred and eighty-nine celiac patients (mean age: 46.6 ± 16.6, 30.2% males) who underwent CE for alarm symptoms (n = 86, 45.5%) or non-responsive CD (n = 103, 54.5%) were included. Diagnostic yield (DY), therapeutic impact and safety were analyzed.

Results:

Capsule endoscopy was completed in 95.2% of patients (small bowel transit time: 270.5 ± 100.2 min). Global DY was 67.2%, detecting atrophic mucosa (n = 92, 48.7%), ulcerative jejunoileitis (n = 21, 11.1%), intestinal lymphoma (n = 7, 3.7%) and other enteropathies (n = 7, 3.7%, six Crohn's disease cases and one neuroendocrine tumor). The DY of CE was significantly higher in patients presenting with non-responsive disease compared to patients with alarm symptoms (73.8% vs 59.3%, P = 0.035). The new findings of the CE modified management in 59.3% of the cases. There were no major complications.

Conclusion:

Capsule endoscopy may be a moderately helpful and safe diagnostic tool in the suspicion of complicated CD, modifying the clinical course of these patients.

© 2018 Japan Gastroenterological Endoscopy Society.

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