RT Journal Article
SR Electronic
T1 OC-022 Endoscopy Pitfalls in Celiac Disease Diagnosis; a Multicentre Study
JF Gut
JO Gut
FD BMJ Publishing Group Ltd and British Society of Gastroenterology
SP A10
OP A10
DO 10.1136/gutjnl-2013-304907.022
VO 62
IS Suppl 1
A1 K Rostami
A1 M Rostami Nejad Vincenzo Villanacci
A1 Sabine Hogg- Kollars
A1 Umberto Volta
A1 Stefania Manenti
A1 Mohammad Reza Zali
A1 Giacomo Caio
A1 Paolo Giovenali
A1 Ausrine Barakauskiene
A1 Edita Kazenaite
A1 Gabriel Becheanu
A1 Mircea Diculescu
A1 Salvatore Pellegrino
A1 Giuseppe Magazzù
A1 Giovanni Cas
YR 2013
UL http://gut.bmj.com/content/62/Suppl_1/A10.1.abstract
AB Introduction The traditional diagnosis of celiac disease (CD) requires a small bowel biopsy to identify at histology the characteristic mucosal changes. The current biopsy practise among endoscopists for celiac disease is in most part unknown. The aims of this study were to compare the different diagnostic criteria in various centres in Italy, Iran, Lithuania, Romania and the UK, the methodological approach to the biopsy and to investigate the pitfalls of CD diagnosis. To measure the number of specimens submitted during duodenal biopsy among patients in Italy, Iran, Lithuania, Romania and the UK, and to determine the incremental diagnostic yield of adherence to the recommended number of specimens. Methods A total of 931 patients who underwent duodenal biopsy for CD were recruited prospectively at nine centres in European and Middle East countries. Small-bowel biopsies were obtained from the duodenal bulb and the second part of the duodenum (and from the duodenal bulb when it had a micronodular appearance). The histopathological appearances were described according to the modified Marsh classification. Results The most frequent degree of villous atrophy amongst Iranian subjects was 3A and that of the rest of the study population was 3C. The most common number of biopsy specimens for Romanian subjects was 1 (52%) followed by 2 for Iranian (56%), 3 for Lithuanian (66.7%) and British patients (65%) and 4 for Italian patients (48.3%). The main presenting symptom was anaemia (18.7%) followed by malabsorption (10.5%), diarrhoea (9.3%) and dyspepsia (8.2%). Conclusion Taking less biopsy samples than recommended will have a negative impact in detecting massive number of undiagnosed cases. As CD is more common with atypical presentation, taking 4 duodenal biopsies is mandatory for an accurate diagnosis or its exclusion. Disclosure of Interest None Declared