Color masking improves classification of celiac disease in videocapsule endoscopy images

Background: Because of its technical characteristics (i.e. 8-fold magnification, capability to inspect the entire small bowel) and minimal invasiveness, videocapsule endoscopy (VCE) has been proposed as a useful tool for managing patients with celiac disease (CD). Key Messages: Although VCE has been found to be highly sensitive and specific in identifying CD endoscopic markers, it is still inadequate to replace esophagogastroduodenoscopy (EGD) with biopsies in the diagnosis of CD. Nevertheless, it represents a reliable alternative in patients unable or unwilling to undergo EGD. Up to now, available studies have failed to identify any correlation between the length of small bowel involvement and the severity of symptoms. The available evidence on the use of VCE in diagnosing CD in equivocal cases (patients with positive serology and negative or nonspecific histology or those with negative serology and histologically proven villous atrophy) is limited, and its role is still under discussion. In CD patients not improving on gluten-free diet, a complete workup is necessary. In patients with nonresponsive (NRCD) or refractory CD (RCD), VCE has been shown to be able not only to detect significant findings, driving further management, but also to rule out major complications. Nevertheless, in this setting, the inability of VCE to take tissue samples and the risk of capsule retention can represent major limitations. Conclusions: At the present time, for diagnostic purposes, VCE can be proposed only in patients unable or unwilling to undergo EGD, whereas it could be useful in some equivocal cases. Conversely, there is no room for VCE either to estimate the length of the small bowel affected by villous atrophy or to follow up patients improving on gluten-free diet. In patients with NRCD or RCD, VCE can play a role, but it should be combined with other diagnostic techniques.

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The Prevalence of Occult Celiac Disease among Patients with Functional Dyspepsia: A Study from the Western Region of Iran

Gastroenterology Research and Practice ◽

10.1155/2010/170702 ◽

2010 ◽

Vol 2010 ◽

pp. 1-4 ◽

Cited By ~ 5

Author(s):

Ali Asghar Keshavarz ◽

Homayoon Bashiri ◽

Alireza Ahmadi ◽

Shahrzad Bazargan-Hejazi

Keyword(s):

Celiac Disease ◽

Functional Dyspepsia ◽

Western Region ◽

Cross Sectional ◽

Diagnostic Biopsy ◽

History Of ◽

The Western Region ◽

Upper Abdominal ◽

Recruitment Period

Objective. The prevalence of Celiac Disease (CD) is high in Iran, and evaluation of CD is not part of the routine screening procedure for dyspeptic patients; therefore, cases of occult CD may be missed. This study aimed to investigate the prevalence of occult CD among dyspeptic patients who presented at a gastroenterology clinic in the Western region of Iran.Methods. In this descriptive, cross-sectional prospective study, patients who had a history of at least 12 weeks of upper abdominal discomfort were eligible to participate in the study during a 14-month recruitment period. Patients with a clinical or paraclinical data in favor of organic causes were excluded from the study. Enrolled patients were screened for IgA antiendomysium antibody (EMA) and IgA antitissue transglutaminase antibody (tTG). Those who screened positive for EMA/tTG received a confirmatory diagnostic biopsy for Marsh classification of CD.Results. From 225 potential participants with dyspepsia, 55 patients were excluded due to having explainable organic causes. The study sample included 170 patients with “functional dyspepsia.” Mean age of participants was 31 years and 55.8% were female. Twelve patients (7%) had positive tests (EMA/tTG), of which 10 were female (83.4%). According to Rome II criteria, all twelve patients with positive tests had “dysmotility type dyspepsia.” Based on Marsh classification, six patients were consistent with “Marsh I,” four with “Marsh II,” and two with the “Marsh III” classification.Conclusions. In this study, the prevalence of CD in dyspeptic patients was high. As a result, this study suggests that screening by serology tests (EMA/tTG) is justifiable for the detection of CD among functional dyspeptic patients in the tertiary centers in our country.

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Celiac disease diagnosis from videocapsule endoscopy images with residual learning and deep feature extraction

Computer Methods and Programs in Biomedicine ◽

10.1016/j.cmpb.2019.105236 ◽

2020 ◽

Vol 187 ◽

pp. 105236 ◽

Cited By ~ 2

Author(s):

Xinle Wang ◽

Haiyang Qian ◽

Edward J. Ciaccio ◽

Suzanne K. Lewis ◽

Govind Bhagat ◽

...

Keyword(s):

Feature Extraction ◽

Celiac Disease ◽

Disease Diagnosis ◽

Residual Learning ◽

Deep Feature ◽

Videocapsule Endoscopy ◽

Deep Feature Extraction ◽

Celiac Disease Diagnosis

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Celiac Disease Detection from Videocapsule Endoscopy Images Using Strip Principal Component Analysis

IEEE/ACM Transactions on Computational Biology and Bioinformatics ◽

10.1109/tcbb.2019.2953701 ◽

2020 ◽

pp. 1-1 ◽

Cited By ~ 4

Author(s):

Bing Nan Nan Li ◽

Xinle Wang ◽

Rong Wang ◽

Teng Zhou ◽

Rongke Gao ◽

...

Keyword(s):

Principal Component Analysis ◽

Celiac Disease ◽

Principal Component ◽

Component Analysis ◽

Disease Detection ◽

Videocapsule Endoscopy

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Gluten-Sensitive Enteropathy (Celiac Disease): Controversies in Diagnosis and Classification

Archives of Pathology & Laboratory Medicine ◽

10.5858/134.6.826 ◽

2010 ◽

Vol 134 (6) ◽

pp. 826-836 ◽

Cited By ~ 8

Author(s):

Arzu Ensari

Keyword(s):

Celiac Disease ◽

Disease Diagnosis ◽

Classification Systems ◽

Intestinal Biopsy ◽

Inflammatory Disorder ◽

Chronic Inflammatory Disorder ◽

Pathologic Features ◽

Gluten Sensitive Enteropathy ◽

Intraepithelial Lymphocytosis

Abstract Context.—Celiac disease, or gluten-sensitive enteropathy, is a chronic inflammatory disorder of the small intestine characterized by malabsorption after ingestion of gluten in individuals with a certain genetic background. Clinical presentation can vary from full-blown malabsorption to subtle and atypical symptoms. Diagnosis currently relies on clinicopathologic studies including mucosal biopsy, serologic tests, and the effects of a diet free of gluten on the symptoms. Mucosal pathologic features are also variable, ranging from mild abnormalities, including intraepithelial lymphocytosis, to completely flat mucosa. Since patients with minimal histologic lesion of intraepithelial lymphocytosis often present with normal serologic findings, biopsy diagnosis becomes more important for identifying such individuals. Classification of mucosal pathology in gluten-sensitive enteropathy has been a subject of controversy among pathologists and needs to be revised according to the current understanding of the disease. Objectives.—To highlight the variations in clinical and pathologic presentation of gluten-sensitive enteropathy, to emphasize the importance of small-intestinal biopsy evaluation in the diagnosis, and to propose a new classification of mucosal pathology in gluten-sensitive enteropathy, in an effort to overcome the problems related to the classification systems currently available. Data Sources.—A review of the literature on clinicopathologic features and the morphologic spectrum of gluten-sensitive enteropathy is presented. Conclusions.—Considering that there are many entities in the differential diagnosis of gluten-sensitive enteropathy, because of the varied clinicopathologic spectrum of the disease, diagnosis depends on good clinicopathologic communication. The classification that is presented in this review is a simple and practical approach to improve clinicopathologic correlation in gluten-sensitive enteropathy.

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