Challenges in endoscopy and histological diagnosis of celiac disease

Rostami, Kamran; Kasturi, Ramana V.; Villanacci, V.; Bassotti, Gabrio; Zambelli, A.

doi:10.1055/s-0030-1256313

Cited by 6 publications

(3 citation statements)

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“…in our multicentre study, only the minority of patients with upper Gi endoscopy and duodenal biopsy except italian cases had ≥ 4 specimens. in the light of the beneficial effect on the histological diagnosis of cD (31), in particular in atypical cases increased adherence to biopsy guidelines is warranted. in typical cases, as suggested by European Society for pediatric Gastroenterology and Nutrition (ESpGaN), the endoscopy and biopsy obviously might be avoided.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic and histological pitfalls in the diagnosis of celiac disease: a multicentre study assessing the current practice

Rostami‐Nejad

Villanacci

Hogg-Kollars

et al. 2013

Rev. esp. enferm. dig.

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Section: Discussionmentioning

confidence: 99%

Endoscopic and histological pitfalls in the diagnosis of celiac disease: a multicentre study assessing the current practice

Rostami‐Nejad

Villanacci

Hogg-Kollars

et al. 2013

Rev. esp. enferm. dig.

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“…Biopsies are performed on patients because of abnormal serology, high index of suspicion, routine duodenal biopsy at endoscopy for disease indications other than celiac disease or endoscopic visualization of villous atrophy 8 9 . A recent survey revealed a discrepancy between the number of biopsies recommended and real-life practice, showing that 63 % of patients had fewer than four duodenal biopsies 10 .…”

Section: Introductionmentioning

confidence: 99%

Factors associated with number of duodenal samples obtained in suspected celiac disease

et al. 2017

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Background and study aims Many people with celiac disease are undiagnosed and there is evidence that insufficient duodenal samples may contribute to underdiagnosis. The aims of this study were to investigate whether more samples leads to a greater likelihood of a diagnosis of celiac disease and to elucidate factors that influence the number of samples collected. Patients and methods We identified patients from two community hospitals who were undergoing duodenal biopsy for indications (as identified by International Classification of Diseases code) compatible with possible celiac disease. Three cohorts were evaluated: no celiac disease (NCD, normal villi), celiac disease (villous atrophy, Marsh score 3), and possible celiac disease (PCD, Marsh score < 3). Endoscopic features, indication, setting, trainee presence, and patient demographic details were evaluated for their role in sample collection. Results 5997 patients met the inclusion criteria. Patients with a final diagnosis of celiac disease had a median of 4 specimens collected. The percentage of patients diagnosed with celiac disease with one sample was 0.3 % compared with 12.8 % of those with six samples ( P = 0.001). Patient factors that positively correlated with the number of samples collected were endoscopic features, demographic details, and indication ( P = 0.001). Endoscopist factors that positively correlated with the number of samples collected were absence of a trainee, pediatric gastroenterologist, and outpatient setting ( P < 0.001). Conclusions Histological diagnosis of celiac disease significantly increased with six samples. Multiple factors influenced whether adequate biopsies were taken. Adherence to guidelines may increase the diagnosis rate of celiac disease.

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“…In clinical practice, however, even experienced endoscopists are often not compliant to the "multiple biopsy" guidelines [6], with lower rates of adherence particularly among physicians with high procedure volume [7]. If the site of mucosal damage could be certainly identified prior to obtaining the specimen, this would minimize the number of biopsies for histological evaluation, reduce the invasiveness of the endoscopic procedure itself and save time and resources.…”

Section: Introductionmentioning

confidence: 99%

Narrow band imaging combined with water immersion technique in the diagnosis of celiac disease

Valitutti

Oliva

Iorfida

et al. 2014

Digestive and Liver Disease

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Challenges in endoscopy and histological diagnosis of celiac disease

Cited by 6 publications

References 0 publications

Endoscopic and histological pitfalls in the diagnosis of celiac disease: a multicentre study assessing the current practice

Endoscopic and histological pitfalls in the diagnosis of celiac disease: a multicentre study assessing the current practice

Factors associated with number of duodenal samples obtained in suspected celiac disease

Narrow band imaging combined with water immersion technique in the diagnosis of celiac disease

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