Refractory Whipple’s Disease with Anaemia: First Lessons from Capsule Endoscopy

Fritscher-Ravens, Annette; Swain, C. Paul; Herbay, A. von

doi:10.1055/s-2004-814537

Cited by 26 publications

(11 citation statements)

References 9 publications

(13 reference statements)

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“…86 VCE has also recently shown in patients with a diffuse intestinal disorder that lesions may extend down to the distal part of the ileum. Typical endoscopic patterns have been described in Whipple's disease, 87 that improve after antibiotics. 88 In gastro-intestinal graft-versus-host disease, VCE is more effective and less invasive than gastroscopy to detect mucosal changes and can significantly influence the management of the patient.…”

Section: Miscellaneous Potential Indicationsmentioning

confidence: 94%

Capsule endoscopy in 2005: Facts and perspectives

Delvaux

2006

Best Practice & Research Clinical Gastroenterology

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Section: Miscellaneous Potential Indicationsmentioning

confidence: 94%

Capsule endoscopy in 2005: Facts and perspectives

Delvaux

2006

Best Practice & Research Clinical Gastroenterology

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“…This is explained by the fact that previous investigative techniques allowed only limited access to the intestinal mucosa, i.e. before CE and DBE became available [41] . Moreover, CE is also a useful noninvasive method to determine the response to treatment, which has to be maintained for at least two years, and occasionally five years in order to avoid relapse, especially of the neurological manifestations [42] .…”

Section: Whipple's Disease An Example Of Diffuse Intestinal Infectiomentioning

confidence: 99%

Capsule endoscopy in non-steroidal anti-inflammatory drugs-enteropathy and miscellaneous, rare intestinal diseases

Gay¹,

Delvaux²,

Frederic³

2008

WJG

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Despite significant advances over the last decade, mucosal lesions of the small bowel are poorly detected by imaging studies such as CT scan, MRI-enteroclysis and contrast-enhanced abdominal ultrasound. Capsule endoscopy (CE) has dramatically changed the diagnostic approach to intestinal diseases. Moreover, the use of CE can be extended to include other conditions. However, it is difficult to assess the positive influence of CE on patient outcomes in conditions involving a small number of patients, or in critically ill and difficult to examine patients. CE has the advantage of diagnosing intestinal lesions and of directing the use of double balloon enteroscopy (DBE) in order to obtain biopsy specimens. Moreover, CE allows repeated assessment in chronic conditions, especially to detect relapse of an infectious disease.

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“…On the other hand May et al [77] clearly demonstrated that when chronic abdominal pain is associated with other signs or symptoms (weight loss > 10% of body weight, inflammation shown by laboratory tests, chronic anemia, or suspected mid-gastrointestinal bleeding) relevant, or potentially relevant, findings are diagnosed by capsule endoscopy in about 60% of cases. C a p s u l e e n d o s c o p y h a s a l s o b e e n u s e d , w i t h promising results, in other rare clinical conditions such as indeterminate colitis [78,79] , small bowel transplantation [80] , graft versus host disease [81,82] , protein losing entheropathy [83] , primitive lymphangectasia [84] (mostly in the pediatric population), Whipple disease [85] and irritable bowel syndrome (with clinical suspicion of celiac disease) [86] .…”

Section: Other Indicationsmentioning

confidence: 99%

Small bowel capsule endoscopy in 2007: Indications, risks and limitations

Rondonotti¹,

Villa²,

Mulder³

et al. 2007

WJG

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Capsule endoscopy has revoluzionized the study of the small bowel by providing a reliable method to evaluate, endoscopically, the entire small bowel. In the last six years several papers have been published exploring the possible role of this examination in different clinical conditions. At the present time capsule endoscopy is generally recommended as a third examination, after negative bidirectional endoscopy, in patients with obscure gastrointestinal bleeding. A growing body of evidence suggests also an important role for this examination in other clinical conditions such as Crohn's disease, celiac disease, small bowel polyposis syndromes or small bowel tumors. The main complication of this examination is the retention of the device at the site of a previously unknown small bowel stricture. However there are also some other open issues mainly due to technical limitations of this tool (which is not driven from remote control, is unable to take biopsies, to insufflate air, to suck fluids or debris and sometimes to correctly size and locate lesions).The recently developed double balloon enteroscope, owing to its capability to explore a large part of the small bowel and to take targeted biopsies, although being invasive and time consuming, can overcome some limitations of capsule endoscopy. At the present time, in the majority of clinical conditions (i.e. obscure GI bleeding), the winning strategy seems to be to couple these two techniques to explore the small bowel in a painless, safe and complete way (with capsule endoscopy) and to define and treat the lesions identified (with double balloon enteroscopy).

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Refractory Whipple’s Disease with Anaemia: First Lessons from Capsule Endoscopy

Cited by 26 publications

References 9 publications

Capsule endoscopy in 2005: Facts and perspectives

Capsule endoscopy in 2005: Facts and perspectives

Capsule endoscopy in non-steroidal anti-inflammatory drugs-enteropathy and miscellaneous, rare intestinal diseases

Small bowel capsule endoscopy in 2007: Indications, risks and limitations

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