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PTU-013 Capsule Endoscopy in Young Patients with Iron Deficiency Anaemia
  1. E Rondonotti1,
  2. DE Yung2,
  3. A Giannakou3,
  4. B Rosa4,
  5. E Toth5,
  6. A Lucendo6,
  7. R Sidhu7,
  8. H Beaumont8,
  9. P Ellul9,
  10. L Negreanu10,
  11. VA Jiménez-García11,
  12. JN Plevris2,12,
  13. A Koulaouzidis2,
  14. on behalf of the Capsule Endoscopy in Young IDA Patients research group
  1. 1Valduce Hospital, Como, Italy
  2. 2RIE, Edinburgh, UK
  3. 3Open University, Nicosia, Cyprus
  4. 4Hospital da Senhora da Oliveira, Guimarães, Portugal
  5. 5SUH, Malmö, Sweden
  6. 6Tomelloso Hospital, Tomelloso, Spain
  7. 7Royal Hallamshire Hospital, Sheffield, UK
  8. 8VUMC, Amsterdam, Netherlands
  9. 9Mater Dei Hospital, Malta, Malta
  10. 10Bucharest University Hospital, Bucharest, Romania
  11. 11University Virgen Macarena Hospital, Seville, Spain
  12. 12UoE, Edinburgh, UK

Abstract

Introduction Recent data imply young pts (≤50 yrs) investigated with capsule endoscopy(CE) for iron deficiency anaemia(IDA) show higher diagnostic yield(DY) for sinister findings. We aim to investigate DY of CE in a large cohort of young IDA pts and factors associated with sinister pathology.

Methods Retrospective multicentre study (2010–2015); consecutive pts ≤ 50 yrs undergoing CE for IDA at 19 centres in 12 countries. Exclusion criteria: ongoing/previous gastrointestinal(GI) bleeding; age > 50 or <19; comorbidities associated with IDA e.g. inflammatory bowel disease, coeliac disease. Data retrieved: indication for SBCE, investigations before CE (Hb, MCV, GI endoscopies/imaging, coeliac biopsies/serology), medications (NSAIDs, antiplatelets, warfarin/heparin), findings and final diagnosis. Clinical findings were analysed by multivariate logistic regression, and Akaike Information Criterion was used to include or exclude predictors.

Results 389 pts (262 F/127 M; mean age 39.4±9.3 yrs) were recruited. 169 pts (43.4%) were excluded from further analysis because clinically relevant data were not available; 220 pts were included in final analysis. They were grouped according to final diagnosis: neoplastic pathology (11/220; 5.0%); non-neoplastic but clinically significant findings (60/220; 27.3%); normal/minimal findings (149/220; 67.7%). The most common non-neoplastic findings were angiodysplasias(22/60) and Crohn’s disease(15/60). On multivariate analysis, MCV was associated with occurrence of neoplasia (OR: 0.96; 95%CI:0.93-0.99; p = 0.033), i.e. the odds of SB neoplasia increased 4% for every unit of decrease in MCV. Weak evidence existed for the association between use of antiplatelet drugs and risk of SB neoplasms (OR: 5.83; 95%CI: 1.0–34.0; p = 0.05).

Conclusion In IDA patients ≤50 years, overall DY of SBCE for significant findings is 32.3%. Around 5% are diagnosed with SB malignancy. In this cohort, lower MCV or antiplatelet use have been associated with higher DY for SB neoplasia or clinically significant findings on CE.

References 1 Koulaouzidis A, et al. The use of small-bowel capsule endoscopy in iron-deficiency anaemia alone; be aware of the young anaemic patient. Scand J Gastroenterol 2012;47:1094–100.

2 Sidhu PS, et al. The utility of capsule endoscopy in patients under 50 years of age with recurrent iron deficiency anaemia: Is the juice worth the squeeze? Gastroenterol Res Prac 2015:948574.

Disclosure of Interest E. Rondonotti: None Declared, D. Yung Grant/research support from: Dr Falk/ Core F1/F2 Award 2015, A. Giannakou: None Declared, B. Rosa: None Declared, E. Toth: None Declared, A. Lucendo: None Declared, R. Sidhu: None Declared, H. Beaumont: None Declared, P. Ellul: None Declared, L. Negreanu: None Declared, V. Jiménez-García: None Declared, J. Plevris: None Declared, A. Koulaouzidis: None Declared

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