Atlas DS et al. – Mucosal abnormalities were observed by capsule endoscopy(CE) in patients with both nonresponsive celiac disease(CD) and uncomplicated CD. CE can detect severe complications in patients with nonresponsive CD.
Case-control study was done at Tertiary-care center.
42 consecutive patients with nonresponsive CD and 84 age- and sex-matched CD-free controls who underwent CE were included. In addition, capsules taken after treatment with a GFD were retrospectively evaluated in 30 patients with uncomplicated CD.
Diagnostic accuracy of CE for the detection of mucosal abnormalities in nonresponsive CD was measured.
Macroscopic features of villous atrophy were detected in 13 of 42 patients (31%) with nonresponsive CD compared with none among 84 CD-free controls and 14 of 30 patients (47%) with uncomplicated CD.
Among nonresponsive CD cases, the overall sensitivity and specificity of CE for the detection of any degree of villous atrophy as graded by histology were 56% and 85%, respectively.
Single or multiple erosions/ulcerations of the gut were observed in 19% of nonresponsive CD patients, 18% of CD-free controls, and 31% of patients with uncomplicated CD (P=.35).
Presence of erosions/ulcerations was associated with increased aspirin/nonsteroidal anti-inflammatory drug use in nonresponsive CD (P=.05).
Two severe complications (ulcerative jejunitis and adenocarcinoma) were detected by CE in nonresponsive CD.
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