The role of small bowel follow-through examination in the diagnosis of coeliac disease

1976 ◽  
Vol 49 (584) ◽  
pp. 660-664 ◽  
Author(s):  
J. B. Masterson ◽  
E. C. Sweeney
Keyword(s):  
2020 ◽  
Vol 44 (5) ◽  
pp. 753-761 ◽  
Author(s):  
S. Chetcuti Zammit ◽  
M. Kurien ◽  
D.S. Sanders ◽  
R. Sidhu

2017 ◽  
Vol 62 (1) ◽  
pp. 25-27 ◽  
Author(s):  
Siba P Paul ◽  
Matthew Hoghton ◽  
Bhupinder Sandhu

The European guidelines for diagnosing coeliac disease in children were revised in 2012. These recommend that in symptomatic children, a diagnosis of coeliac disease can be made without small-bowel biopsies provided their anti-tissue transglutaminase (anti-tTG) titre is >10 times of upper-limit-of-normal (>10×ULN) and anti-endomysial antibody is positive. In order to firm up the diagnosis in these children with very high anti-tTG titre, HLA-DQ2/DQ8 should be checked and be positive. Approximately 25–40% of white Caucasian population has HLA-DQ2/DQ8 haplotype. However, only 0.1–1% of the population will develop coeliac disease. Therefore, HLA-DQ2/DQ8 testing must not be done to ‘screen’ or ‘diagnose’ children with coeliac disease. Its use by paediatricians should be limited to children with anti-tTG>10×ULN, where the diagnosis of coeliac disease is being made on serology alone. A review of case referrals made to a tertiary paediatric gastroenterology centre in Southwest England demonstrated that HLA-DQ2/DQ8 testing is being requested inappropriately both in primary and secondary care suggesting a poor understanding of its role in diagnosis of coeliac disease. This article aims to clarify the role of HLA-DQ2/DQ8 testing for clinicians working in non-specialist settings.


2019 ◽  
Vol 28 (1) ◽  
pp. 15-22 ◽  
Author(s):  
Stefania Chetcuti Zammit ◽  
David S Sanders ◽  
Simon S Cross

Background & Aims: There is no literature on the role of repeat small bowel capsule endoscopy (SBCE) in patients with refractory coeliac disease (RCD) following treatment with steroids +/- immunosuppressants.Methods: The findings on SBCEs from a group of patients with histologically proven RCD (n=23) were compared to the findings from patients with uncomplicated coeliac disease (n=48). All patients had concurrent duodenal histology and serology taken at the time of SBCE.Results: Patients with RCD had a greater extent of mucosal involvement on SBCE than patients with uncomplicated CD (42.4±34.1% vs 9.7±21.7%, p=0.0001). Following treatment with steroids and / or immunosuppressants, patients with RCD had an improvement in the extent of affected small bowel mucosa (42.4±34.1% vs 26.4±28.9% p=0.012). There was no statistical difference in histology and serology taken at the time of the first and second SBCE in patients with RCD.Conclusions: Our study suggests that SBCE is valuable in documenting the extent of mucosal involvement in patients with RCD. This is the first study that delineates the value of a second look SBCE to assess improvement in the extent of disease in the small bowel following treatment.


2005 ◽  
Vol 43 (05) ◽  
Author(s):  
M Babos ◽  
A Palkó ◽  
L Kardos ◽  
I Kiss ◽  
F Nagy

Digestion ◽  
2020 ◽  
pp. 1-9
Author(s):  
Roberta Elisa Rossi ◽  
Luca Elli ◽  
Federica Branchi ◽  
Dario Conte ◽  
Sara Massironi

<b><i>Background and Aim:</i></b> Small-bowel neuroendocrine neoplasm (sbNEN) diagnosis has improved with double-balloon enteroscopy (DBE). DBE efficacy in the detection of sbNENs is unknown. We aimed to report the experience at a single referral center for NENs. <b><i>Methods:</i></b> All consecutive patients with a suspected sbNEN selected for diagnostic DBE were enrolled. <b><i>Results:</i></b> Between 2011 and 2016, 25 patients were referred for a suspected sbNEN. In 15/25 patients, a primary NEN was detected outside the small bowel; in 4, NEN was excluded. After extensive workup, 6 patients (4 males, median age 50 years) underwent DBE (3 anterograde, 2 retrograde, and 1 both; median time: 60 min; median insertion 200 cm). DBE was positive in 3 patients: one had an ileal 2-cm NEN G1, one had an ileal 1.3-cm NEN G1, and one had an ileal 1-cm NEN G2, all surgically removed. Of the 3 other patients, one had a metastatic NEN of unknown primary, the other two had small intestinal NENs, both surgically removed (1.6-cm G1 and G2 NEN). DBE showed a sensitivity of 60% and, in absence of false-positive results, a specificity of 100%. Accuracy resulted 67%. No complications were observed. <b><i>Conclusions:</i></b> In line with data from the literature, the present series showed that DBE is a safe and effective procedure in the diagnosis of sbNENs. Further studies are needed to better clarify the diagnostic role of DBE in the neuroendocrine tumor setting and its relationship with other techniques.


Endoscopy ◽  
2006 ◽  
Vol 38 (8) ◽  
pp. 836-840 ◽  
Author(s):  
Z.-Z. Ge ◽  
H.-Y. Chen ◽  
Y.-J. Gao ◽  
Y.-B. Hu ◽  
S.-D. Xiao

2011 ◽  
Vol 65 (3) ◽  
pp. 242-247 ◽  
Author(s):  
Carolina Arguelles-Grande ◽  
Christina A Tennyson ◽  
Suzanne K Lewis ◽  
Peter H R Green ◽  
Govind Bhagat
Keyword(s):  

1986 ◽  
Vol 91 (3) ◽  
pp. 791-792 ◽  
Author(s):  
Alan D. Phillips ◽  
John A. Walker-Smith

2015 ◽  
Vol 82 (4) ◽  
pp. 600-607 ◽  
Author(s):  
Mouen A. Khashab ◽  
Shabana F. Pasha ◽  
V. Raman Muthusamy ◽  
Ruben D. Acosta ◽  
David H. Bruining ◽  
...  
Keyword(s):  

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