Capsule endoscopy in adult celiac disease: a potential role in equivocal cases of celiac disease?

Kurien, Matthew; Evans, K E; Aziz, Imran; Sidhu, Reena; Drew, K; Rogers, Thea L.; McAlindon, Mark E.; Sanders, David S.

doi:10.1016/j.gie.2012.09.031

Cited by 57 publications

(42 citation statements)

References 26 publications

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“…They found that VCE did not reveal any endoscopic features of CD in all the 8 enrolled patients. More recently, Kurien et al [27] evaluated 30 patients with nonspecific duodenal histology (namely Marsh I or Marsh II). Of them, only 6 (20%) had positive serology (EMA or TTG), and only one was finally diagnosed with CD and another one with Crohn's disease.…”

Section: Equivocal Casesmentioning

confidence: 99%

“…In the study on equivocal CD cases by Kurien et al [27], the authors included 32 patients with antibody-negative VA. These patients were extensively investigated for CD including HLA testing, by monitoring response to GFD and in some cases by repeating duodenal biopsies.…”

Section: Equivocal Casesmentioning

confidence: 99%

“…Moreover, a wide heterogeneity of patients included either in different studies or within the same study has to be mentioned. Some studies include mostly patients with NRCD, while other include patients with RCD or patients at increased risk of developing small bowel neoplasm [27,40,41,42,43,44,45,46]. These papers often lack a control group, and the majority of them test VCE as the only diagnostic procedure.…”

Section: Nonresponsive and Refractory CDmentioning

confidence: 99%

“…In light of these studies (summarized in table 1) [27,40,41,42,43,44,45,46], the use of VCE in NRCD or RCD patients may therefore be justified, keeping in mind that data coming from this procedure have to be part of a complex diagnostic workup including EGD with biopsies, flow cytometry, radiology and device-assisted enteroscopy [1,16,18,47]. In line with this, the most recently published studies [42,45] focused their attention on the contribution of VCE not only to the diagnostic process but also as a possible predictor of poor prognosis.…”

Section: Nonresponsive and Refractory CDmentioning

confidence: 99%

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Videocapsule Endoscopy in Celiac Disease: Indications and Timing

Rondonotti¹,

Paggi²

2015

Dig Dis

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Background: Because of its technical characteristics (i.e. 8-fold magnification, capability to inspect the entire small bowel) and minimal invasiveness, videocapsule endoscopy (VCE) has been proposed as a useful tool for managing patients with celiac disease (CD). Key Messages: Although VCE has been found to be highly sensitive and specific in identifying CD endoscopic markers, it is still inadequate to replace esophagogastroduodenoscopy (EGD) with biopsies in the diagnosis of CD. Nevertheless, it represents a reliable alternative in patients unable or unwilling to undergo EGD. Up to now, available studies have failed to identify any correlation between the length of small bowel involvement and the severity of symptoms. The available evidence on the use of VCE in diagnosing CD in equivocal cases (patients with positive serology and negative or nonspecific histology or those with negative serology and histologically proven villous atrophy) is limited, and its role is still under discussion. In CD patients not improving on gluten-free diet, a complete workup is necessary. In patients with nonresponsive (NRCD) or refractory CD (RCD), VCE has been shown to be able not only to detect significant findings, driving further management, but also to rule out major complications. Nevertheless, in this setting, the inability of VCE to take tissue samples and the risk of capsule retention can represent major limitations. Conclusions: At the present time, for diagnostic purposes, VCE can be proposed only in patients unable or unwilling to undergo EGD, whereas it could be useful in some equivocal cases. Conversely, there is no room for VCE either to estimate the length of the small bowel affected by villous atrophy or to follow up patients improving on gluten-free diet. In patients with NRCD or RCD, VCE can play a role, but it should be combined with other diagnostic techniques.

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Section: Equivocal Casesmentioning

confidence: 99%

Section: Equivocal Casesmentioning

confidence: 99%

Section: Nonresponsive and Refractory CDmentioning

confidence: 99%

Section: Nonresponsive and Refractory CDmentioning

confidence: 99%

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Videocapsule Endoscopy in Celiac Disease: Indications and Timing

Rondonotti¹,

Paggi²

2015

Dig Dis

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“…In uncertain celiac disease cases (negative antibodies and atrophy in the duodenal biopsy) CE has revealed lesions consistent with CD in 6 % of patients (75).…”

Section: Differential Diagnosis With Other Intestinal Conditionsmentioning

confidence: 99%

Indications of capsule endoscopy in Crohn's disease

Luján-Sanchis

Sanchis-Artero

Suárez-Callol

et al. 2014

Rev. esp. enferm. dig.

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Capsule endoscopy currently plays a relevant role for Crohn's disease. This manuscript will discuss the current indications and practical uses of capsule endoscopy in this disease. It is a non-invasive technique that represents a significant advance in the endoscopic diagnosis of small bowel conditions. These circumstances, together with its diagnostic yield and excellent tolerability, make it considerably acceptable by both patients and physicians. This paper discusses the current evidence on the specific circumstances where capsule endoscopy may be indicated for three specific scenarios: Suspected Crohn's disease, indeterminate colitis, and established Crohn's disease, where it plays an extensive role. Furthermore, the impact and implications of capsule endoscopy results for follow-up are reviewed. These recommendations must be interpreted and applied in the setting of the integral, individual management of these patients. Understanding its appropriate use in daily clinical practice and an analysis of results may define endoscopic scoring systems to assess activity and mucosal healing in this condition. The present role of capsule endoscopy for Crohn's disease is subject to ongoing review, and appropriate usage uncovers novel applications likely to result in relevant changes for the future management of these patients.

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Capsule and Small Bowel Endoscopy

and

2015

Yamada' S Textbook of Gastroenterology

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Capsule endoscopy in adult celiac disease: a potential role in equivocal cases of celiac disease?

Cited by 57 publications

References 26 publications

Videocapsule Endoscopy in Celiac Disease: Indications and Timing

Videocapsule Endoscopy in Celiac Disease: Indications and Timing

Indications of capsule endoscopy in Crohn's disease

Capsule and Small Bowel Endoscopy

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