Endoscopy 2020; 52(S 01): S267
DOI: 10.1055/s-0040-1704840
ESGE Days 2020 ePoster presentations
Thursday, April 23, 2020 09:00 – 17:00 Stomach and small intestine ePoster area
© Georg Thieme Verlag KG Stuttgart · New York

UPPER GASTROINTESTINAL TRACT ASSOCIATED LESIONS IN PATIENTS WITH NEWLY DIAGNOSED CELIAC DISEASE

I Enache
1   Carol Davila’ University of Medicine and Pharmacy, Bucharest, Romania
2   Dr Carol Davila Central Military Emergency University Hospital, Bucharest, Romania
,
DV Balaban
1   Carol Davila’ University of Medicine and Pharmacy, Bucharest, Romania
2   Dr Carol Davila Central Military Emergency University Hospital, Bucharest, Romania
,
A Zoican
2   Dr Carol Davila Central Military Emergency University Hospital, Bucharest, Romania
,
A Popp
1   Carol Davila’ University of Medicine and Pharmacy, Bucharest, Romania
3   Alessandrescu Rusescu Institute for Mother and Child Health, Bucharest, Romania
,
S Marin
2   Dr Carol Davila Central Military Emergency University Hospital, Bucharest, Romania
,
RS Costache
1   Carol Davila’ University of Medicine and Pharmacy, Bucharest, Romania
2   Dr Carol Davila Central Military Emergency University Hospital, Bucharest, Romania
,
P Nuta
2   Dr Carol Davila Central Military Emergency University Hospital, Bucharest, Romania
,
FI Radu
2   Dr Carol Davila Central Military Emergency University Hospital, Bucharest, Romania
4   Titu Maiorescu University, Bucharest, Romania
,
D Matei
1   Carol Davila’ University of Medicine and Pharmacy, Bucharest, Romania
,
M Jinga
1   Carol Davila’ University of Medicine and Pharmacy, Bucharest, Romania
2   Dr Carol Davila Central Military Emergency University Hospital, Bucharest, Romania
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

Also available at
 
 

    Aims Celiac disease (CD) in adults is currently diagnosed by CD-specific serology and upper gastrointestinal endoscopy (UGIE) with duodenal biopsy samples. In the last years there´s been a growing interest towards a non-bioptic diagnostic strategy, especially in children but in adults also. In this setting, when the usefulness of endoscopy for CD diagnosis is being questioned, we aimed to see if there are associated lesions detected during endoscopy which could support the indication of UGIE in these patients.

    Methods We recruited all newly diagnosed CD cases during a period of 6 years, according to currently available guidelines. All patients underwent UGIE with multiple duodenal biopsies and were tested for CD-specific serology. Demographic and clinical data were collected from the charts and the endoscopy reports were reevaluated for associated lesions.

    Results Altogether 74 patients were recruited, 75.7% female with a mean age of 40 ± 10.7 years. About two thirds (64.9%) had typical presentation, while the other one third were atypical forms (18.9%) or screen-detected (16.2%). 9 out of the 74 patients (12.2%) had an associated autoimmune disease (type 1 diabetes mellitus or autoimmune thyroid disease).

    Among the study cohort, associated lesions were detected in 56.8% of patients, as follows: esophageal (esophagitis, esophageal candidiasis) - 2.4%, gastric (hiatal hernia, gastritis, gastric ulcer, submucosal tumor) - 88.1%, and 9.5 % presented combined lesions; none of the patients had other endoscopic changes in the duodenum except CD-related findings. Regarding Helicobacter pylori status, 51 out of 74 were tested - 82.4% using rapid urease testing and 17.6% using fecal antigen test and 37% of them were positive.

    Conclusions A significant proportion of newly diagnosed CD patients have associated lesions during the index UGIE. Our results support the use of UGIE in the diagnostic protocol of adult CD, which might change management (further tests, treatment prescriptions) in these patients.


    #