Diagnostic value of confocal endomicroscopy in celiac disease

Günther, Ute; Daum, S; Heller, Frank; Schümann, Michael; Loddenkemper, Christoph; Grünbaum, Maria; Zeitz, Martin; Bojarski, Christian

doi:10.1055/s-0029-1243937

Cited by 43 publications

(30 citation statements)

References 21 publications

(28 reference statements)

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“…Still, eCLE showed high accuracy to diagnose celiac disease, and in patients with established celiac disease even a trend towards higher accuracy for CLE versus histopathology was reported due to sampling error for biopsies. These results have been confirmed in followup trials with respect to villous atrophy and intraepithelial lymphocytes, but not crypt hyperplasia [44]. CLE has even been studied in children for the diagnosis of celiac disease.…”

Section: Endomicroscopy Of the Small Intestinementioning

confidence: 64%

Confocal Laser Endomicroscopy: Applications in Clinical and Translational Science—A Comprehensive Review

Goetz

2012

ISRN Pathology

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Confocal laser endomicroscopy (CLE) is a novel tool in the endoscopist's armamentarium. It allows on-site histological information. The ability of gastroenterologists to interpret such microscopic information has been demonstrated in multiple studies from the upper and lower gastrointestinal tract. Recently, the field of application has expanded to provide hepatobiliary and intra-abdominal CLE imaging. CLE allows "smart," targeted biopsies and is able to guide endoscopic interventions. But CLE is also translational in its approach and permits functional imaging that significantly impacts on our understanding of gastrointestinal diseases. Molecular imaging with CLE allows detection and characterization of lesions and may even be used for prediction of response to targeted therapy. This paper provides a comprehensive review over current applications of CLE in clinical applications and translational science.

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Section: Endomicroscopy Of the Small Intestinementioning

confidence: 64%

Confocal Laser Endomicroscopy: Applications in Clinical and Translational Science—A Comprehensive Review

Goetz

2012

ISRN Pathology

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“…Another study recently reviewed the sensitivity and specificity of eCLE in the evaluation of established CD. 48 In addition to villous atrophy, this study was able to identify IEL using CLE and maybe useful for diagnosing Marsh I CD. However, crypt hypertrophy had a lower sensitivity and specificity than Leong's study.…”

Section: Coeliac Diseasementioning

confidence: 78%

Status of confocal laser endomicroscopy in gastrointestinal disease

Humphris

Swartz

Egan

et al. 2012

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Confocal laser endomicroscopy (CLE) is an advanced imaging technique which combines conventional white light endoscopy (WLE) with an integrated or probe based confocal microscope. This allows microscopic examination of the surface epithelium and in vivo diagnosis during endoscopy. Established CLE applications include the diagnosis of Barrett's oesophagus, gastric intestinal metaplasia, coeliac disease and microscopic colitis. CLE can differentiate hyperplastic from adenomatous polyps in the colon and may obviate the need to biopsy all polyps at endoscopy. CLE is particularly helpful in surveillance endoscopy in inflammatory bowel disease where it has been shown to reduce the number of biopsies required and improve the detection of dysplasia. The future of CLE may be with new contrast agents to allow for molecular tagging and improved endoscopic diagnoses. The aim of this review is to describe the technology and techniques involved in CLE, and discuss the evolving applications in obtaining "virtual biopsy" throughout the GI tract.

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“…3d,e) when using intravenous fluorescein as a contrast agent. Other studies have shown that endomicroscopy can diagnose coeliac disease [55][56][57][58] based on recognition of features relevant to EED, such as villous atrophy, crypt hyperplasia and lymphocyte infiltration. In particular, Venkatesh et al 58 reported successful diagnosis of coeliac disease (100% sensitivity, 80% specificity) in children as young as 1.8 years of age.…”

Section: Microbiota Changesmentioning

confidence: 99%

The potential role of optical biopsy in the study and diagnosis of environmental enteric dysfunction

Thompson

Hughes

Anastasova

et al. 2017

Nat Rev Gastroenterol Hepatol

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| Environmental enteric dysfunction (EED) is a disease of the small intestine affecting children and adults in low and middle income countries. Arising as a consequence of repeated infections, gut inflammation results in impaired intestinal absorptive and barrier function, leading to poor nutrient uptake and ultimately to stunting and other developmental limitations. Progress towards new biomarkers and interventions for EED is hampered by the practical and ethical difficulties of cross-validation with the gold standard of biopsy and histology. Optical biopsy techniques -which can provide minimally invasive or noninvasive alternatives to biopsy -could offer other routes to validation and could potentially be used as point-of-care tests among the general population. This Consensus Statement identifies and reviews the most promising candidate optical biopsy technologies for applications in EED, critically assesses them against criteria identified for successful deployment in developing world settings, and proposes further lines of enquiry. Importantly, many of the techniques discussed could also be adapted to monitor the impaired intestinal barrier in other settings such as IBD, autoimmune enteropathies, coeliac disease, graft-versus-host disease, small intestinal transplantation or critical care. Members of the board and experts met to discuss the horizon scan in London, UK, in November 2015 and San Francisco, USA, in February 2016. Literature searches were performed using Web of Science, as well as through the advice of the advisory board and experts. The results of the horizon scan are presented in this Consensus Statement, which entails a review of EED, a discussion of technologies deemed relevant to EED (based on literature searches and the opinions of the advisory board and experts), and a series of recommendations for the future application of the rele vant technologies to the study and diagnosis of EED. In the Recommendations section, each technology has been assessed according to its suitability for application to EED and this assessment includes an evaluation of the cost, invasiveness and appropriateness for developing countries of each device and/or technique. This assessment was performed in a qualitative manner based on currently available information (for example, the present cost and size of the devices) and the opinions of the authors as to feasible future develop ment. Technique suitability for use in developing countries was determined in a qualitative manner after consideration of the need for advanced infrastructure and high levels of training for either system use or data analysis. Probable deployment time scales have also been assigned to each technique based on the current states of development and the degree of valid ation work that will be required before application to EED. These timescales have been tentatively defined as short-term (suitable for deployment immediately or within ~1 year), mediumterm (suit able for deployment within ~1-3 years) and long-term (suitable for deployme...

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Diagnostic value of confocal endomicroscopy in celiac disease

Cited by 43 publications

References 21 publications

Confocal Laser Endomicroscopy: Applications in Clinical and Translational Science—A Comprehensive Review

Confocal Laser Endomicroscopy: Applications in Clinical and Translational Science—A Comprehensive Review

Status of confocal laser endomicroscopy in gastrointestinal disease

The potential role of optical biopsy in the study and diagnosis of environmental enteric dysfunction

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