caa a22 4500 445797274 CHVBK 20180317145129.0 cr unu---uuuuu 170323e20110201xx s 000 0 eng 10.1007/s10620-010-1290-6 doi (NATIONALLICENCE)springer-10.1007/s10620-010-1290-6 The Role of Capsule Endoscopy in Suspected Celiac Disease Patients with Positive Celiac Serology [Elektronische Daten] [Ilmars Lidums, Adrian Cummins, Edward Teo] Background: Endomysial antibody (EMA) and tissue transglutaminase (tTG) antibody testing is used to screen subjects with suspected celiac disease. However, the traditional gold standard for the diagnosis of celiac disease is histopathology of the small bowel. As villous atrophy may be patchy, duodenal biopsies could potentially miss the abnormalities. Capsule endoscopy can obtain images of the whole small intestine and may be useful in the early diagnosis of celiac disease. Aims: To evaluate suspected celiac disease patients who have positive celiac serology and normal duodenal histology and to determine, with capsule endoscopy, whether these patients have any endoscopic markers of celiac disease. Methods: Twenty-two subjects with positive celiac serology (EMA or tTG) were prospectively evaluated. Eight of the subjects had normal duodenal histology and 14 had duodenal histology consistent with celiac disease. All subjects underwent capsule endoscopy. Endoscopic markers of villous atrophy such as loss of mucosal folds, scalloping, mosaic pattern, and visible vessels were assessed. Results: Eight subjects with normal duodenal histology had normal capsule endoscopy findings. In the 14 subjects with duodenal histology that was consistent with celiac disease, 13 had celiac disease changes seen at capsule endoscopy. One subject with normal capsule endoscopy findings showed Marsh IIIc on duodenal histology. Using duodenal histology as the gold standard, capsule endoscopy had a sensitivity of 93%, specificity of 100%, PPV of 100%, and NPV of 89% in recognizing villous atrophy. Conclusions: Capsule endoscopy is useful in the detection of villous abnormalities in untreated celiac disease. Patients with positive celiac serology (EMA or tTG) and normal duodenal histology are unlikely to have capsule endoscopy markers of villous atrophy. Springer Science+Business Media, LLC, 2010 Celiac disease nationallicence Celiac serology nationallicence Capsule endoscopy nationallicence IgA-EMA : Endomysial IgA antibody nationallicence IgA-tTG : Tissue transglutaminase IgA antibody nationallicence EMA : Endomysial antibody nationallicence tTG : Tissue transglutaminase antibody nationallicence SEM : Standard error of the mean nationallicence PPV : Positive predictive value nationallicence NPV : Negative predictive value nationallicence Lidums Ilmars Department of Gastroenterology and Hepatology, The Queen Elizabeth Hospital, 5011, Woodville South, SA, Australia aut Cummins Adrian Department of Gastroenterology and Hepatology, The Queen Elizabeth Hospital, 5011, Woodville South, SA, Australia aut Teo Edward Department of Gastroenterology and Hepatology, The Queen Elizabeth Hospital, 5011, Woodville South, SA, Australia aut Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/2(2011-02-01), 499-505 0163-2116 56:2<499 2011 56 10620 https://doi.org/10.1007/s10620-010-1290-6 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10620-010-1290-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Lidums Ilmars Department of Gastroenterology and Hepatology, The Queen Elizabeth Hospital, 5011, Woodville South, SA, Australia aut NATIONALLICENCE 700 1- Cummins Adrian Department of Gastroenterology and Hepatology, The Queen Elizabeth Hospital, 5011, Woodville South, SA, Australia aut NATIONALLICENCE 700 1- Teo Edward Department of Gastroenterology and Hepatology, The Queen Elizabeth Hospital, 5011, Woodville South, SA, Australia aut NATIONALLICENCE 773 0- Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/2(2011-02-01), 499-505 0163-2116 56:2<499 2011 56 10620 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer