Is it necessary to use capsular endoscopy to diagnose celiac disease?

• Main Authors: A.I. Parfenov, A.O. Akopova, P.L. Shcherbakov, O.M. Mikheeva, R.B. Gudkova
• Format: Article
• Language: Russian
• Published: "Consilium Medicum" Publishing house 2018-04-01
• Series: Терапевтический архив
• Subjects: video-capsule endoscopy; extent of lesion of small intestine mucosa; celiac disease
• Online Access: http://ter-arkhiv.ru/en/archive/2018/vol-90-4-2018/nuzhna-li-videokapsulnaya-endoskopiya-dlya-diagnostiki-tseliakii_1449/?element
• ISSN: 0040-3660; 2309-5342

Aim. To clarify the indications for capsular endoscopy (CE) in patients with celiac disease. Materials and methods. The study included 10 patients with celiac disease (6 women, 4 men) aged 22 to 69 years. The median age was 42.4±17.5 years. The diagnosis of celiac disease established on the basis of histological examination of the mucous membrane (MM) of the duodenum and detection of antibodies to diaminononane peptide gliadin and to tissue transglutaminase. In three patients celiac disease was diagnosed for the first time, in others – in terms of 3 months to 2 years. CE was performed using a Given Imaging systems (Yokneam, Israel), Olympus (Japan), the obtained data were analyzed using Rapidr® Reade (version 7.0). The results of the endoscopy were compared with the data of 78 patients examined by us, in which the indicators conformed to the normal CE criteria. Results. All patients with celiac disease showed characteristic endoscopic markers of atrophy from the small intestine: scallop, nodularity, decrease in height and number of folds. Paid attention to the mosaic of defeat in the form of "atrophy fields" against a background of slightly modified MM. Erosive-ulcerative lesions of the small intestine were found in 4 patients. Conclusion. Indications for the appointment of CE in patients with celiac disease is the lack of response to treatment, which is based on strict adherence to gluten-free diet, the assumption of erosive and ulcerative lesions MM of the small intestine and refractory form of the disease. CE makes it possible to establish the extent of atrophy from the small intestine, which allows you to use it to evaluate the effectiveness of treatment.