Correlation of Endoscopic and Histological Features in Adults With Suspected Celiac Disease in a Referral Center of Minas Gerais, Brazil

Abstract

-Context -Clinical presentation of celiac disease is extremely variable and the diagnosis relies on serologic tests, mucosal intestinal biopsy and clinic and serologic response to a gluten-free diet. Objectives -To correlate the endoscopic and histological aspects of adult patients with suspicion of celiac disease and to evaluate the interobserver histological agreement. Method -Endoscopic aspects of 80 adult patients were evaluated and correlated with the histological features according the Marsh-Oberhuber classification system. The interobserver histological agreement was based on kappa values. Results -The symptoms of the patients varied largely, with prominence for chronic diarrhea, present in 48 (60%) patients. The endoscopic aspects related with the duodenal villous atrophy had been observed in 32 (40%) patients. There were confirmed 46 cases of celiac disease, with prevalence of 57.5%. The sensitivity, specificity, positive predictive value and negative predictive value of the endoscopic markers for celiac disease diagnosis were of 60.9%, 88.2%, 87.5% and 62.5%. There was moderate interobserver histological agreement (kappa = 0.46). ConclusionsThe endoscopic markers of villous atrophy, although not diagnostic, had assisted in the suspicion and indication of the duodenal biopsies for diagnosis proposal. Histology is sometimes contradictory and new biopsies or opinion of another professional can provide greater diagnostic agreement. HEADINGS -Celiac disease, diagnosis. Endoscopy. Histology.

Comparison of Endoscopic and Histological Findings between Typical and Atypical Celiac Disease in Children

“…The CD is a highly prevalent, non-communicable disease in most parts of the world, including India (prevalence=1%), that can manifest at any age and shows varied clinical presentations [ 10 ]. The proportion of typical CD is higher in children than in adults [ 14 ].…”

“…With increased availability of paediatric UGI endoscopy, many endoscopies are done for reasons other than suspected CD, and the detection of suggestive endoscopic features in the duodenum can alert endoscopists to take a duodenal biopsy and aid in increasing the diagnostic rate of the disease [ 8 ]. A number of macroscopic endoscopic markers of CD have been identified and includes [ 9 10 ]: 1) Scalloping-indented aspect of duodenal folds; 2) Absence or reduction of number of duodenal folds; 3) Mosaic pattern-micro nodular look of mucosa; 4) Grooves and fissuring of mucosa; 5) Sub mucosal vascular pattern; 6) Nodularity.…”

Epidemiological, Endoscopic, Clinical, and Pathological Features of Patients with Celiac Diseases in Southern Littoral of Caspian Sea

“…This lack of a relationship has also been reported in other studies. 34 The present study has some limitations. First of all, most of our patients had been diagnosed with celiac disease many years ago, and therefore, they probably would make mistakes in remembering their initial symptoms.…”

Celiac Disease Investigation with Marsh Classification in Paediatric Population

“…The proportion found in our study was slightly higher than Mansoor et al study. 14 Ackerman et al found that patients with celiac disease were younger, had lower mean haemoglobin levels, and had much more incidents of lengthier periods of anaemia and diarrhoea as compared to those who did not have celiac disease. 15 Another study by Grisolano et al 16 found only 8.7% with celiac disease.…”