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Narrow Band Imaging Predicted Celiac Disease Histology
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Narrow band imaging accurately predicted duodenal villous morphology in celiac disease with high sensitivity and negative predictive value, according to data presented at UEG Week.
“Narrow band imaging (NBI), a simple tool in the new generation endoscopes, is extremely useful in detecting mucosal abnormalities in celiac disease,” Rakesh Kochhar, MD, department of gastroenterology, Postgraduate Institute of Medical Education and Research, India, told Healio Gastroenterology. “It can help in targeting the biopsies in patients who have a patchy disease.”
Kochhar and colleagues compared the accuracy of NBI and histopathology in predicting duodenal villous morphology in celiac disease by performing a prospective, double blind pilot study involving 80 participants (mean age, 26.5 years; 35 women), 60 of whom had positive celiac disease serology, six who were follow-up patients with celiac disease on gluten-free diet and 14 who had dyspepsia without evidence of celiac disease. Patients underwent esophagogastroduodenoscopy with NBI and had four duodenal biopsies taken for histopathological analysis.
NBI identified absent-villous pattern in 27 patients, distorted and blunted-villous pattern in 27 patients and normal-villous pattern in 26 patients. Among the celiac disease seropositive study group, NBI identified that 26 had absent-villous pattern, 24 had distorted and blunted-villous pattern and 10 had normal-villous pattern, whereas histopathology identified 27 with total villous atrophy, 20 with partial villous atrophy and 13 with no villous atrophy. Both NBI and histopathology revealed the celiac disease follow-up and dyspepsia patients had normal villous patterns. Observations between NBI and histopathology were correlated (P<.001), and the overall sensitivity and specificity of NBI for identifying villous pattern were 87.03% and 84.61%, respectively, whereas positive and negative predictive values were 92.16% and 75%, respectively.
“Image enhancement with NBI should be used in patients with suspected celiac disease to increase the diagnostic yield of celiac disease,” Kochhar said. “It may possibly help obviate the need for histological evaluation if other investigators confirm these findings.”
For more information:
Sinha SK. Abstract OP035. Presented at: UEG Week; Oct. 18-22, 2014; Vienna.
Disclosure: The researchers report no relevant financial disclosures.