TY - JOUR
T1 - Capsule endoscopy in young patients with iron deficiency anaemia and negative bidirectional gastrointestinal endoscopy
AU - And the Capsule Endoscopy in Young Patients with IDA research group
AU - Yung, Diana E.
AU - Rondonotti, Emanuele
AU - Giannakou, Andry
AU - Avni, Tomer
AU - Rosa, Bruno
AU - Toth, Ervin
AU - Lucendo, Alfredo J.
AU - Sidhu, Reena
AU - Beaumont, Hanneke
AU - Ellul, Pierre
AU - Negreanu, Lucian
AU - Jiménez-Garcia, Victoria Alejandra
AU - McNamara, Deidre
AU - Kopylov, Uri
AU - Elli, Luca
AU - Triantafyllou, Konstantinos
AU - Shibli, Fahmi
AU - Riccioni, Maria Elena
AU - Bruno, Mauro
AU - Dray, Xavier
AU - Plevris, John N.
AU - Koulaouzidis, A.
AU - Argüelles-Arias, Federico
AU - Becq, Aymeric
AU - Branchi, Federica
AU - Tejero-Bustos, María Ángeles
AU - Cotter, Jose
AU - Eliakim, Rami
AU - Ferretti, Francesca
AU - Gralnek, Ian M.
AU - Herrerias-Gutierrez, Juan Manuel
AU - Hussey, Mary
AU - Jacobs, Maarten
AU - Johansson, Gabriele Wurm
AU - McAlindon, Mark
AU - Montiero, Sara
AU - Nemeth, Artur
AU - Pennazio, Marco
AU - Rattehalli, Deepa
AU - Stemate, Ana
AU - Tortora, Annalisa
AU - Tziatzios, Georgios
N1 - Publisher Copyright:
© 2017, © Author(s) 2017.
PY - 2017/11/1
Y1 - 2017/11/1
N2 - Background: Recent data imply young patients (age ≤50 years) undergoing small-bowel (SB) capsule endoscopy (CE) for iron deficiency anaemia (IDA) show higher diagnostic yield (DY) for sinister pathology. We aimed to investigate DY of CE in a large cohort of young IDA patients, and evaluate factors predicting significant SB pathology. Materials and methods: This was a retrospective, multicentre study (2010–2015) in consecutive, young patients (≤50 years) from 18 centres/12 countries, with negative bidirectional gastrointestinal (GI) endoscopy undergoing SBCE for IDA. Exclusion criteria: previous/ongoing obscure-overt GI bleeding; age <19 or >50 years; comorbidities associated with IDA. Data retrieved: SBCE indications; prior investigations; medications; SBCE findings; final diagnosis. Clinical and laboratory data were analysed by multivariate logistic regression. Results: Data on 389 young IDA patients were retrieved. In total, 169 (43.4%) were excluded due to incomplete clinical data; data from 220 (122F/98M; mean age 40.5 ± 8.6 years) patients were analysed. Some 71 patients had at least one clinically significant SBCE finding (DY: 32.3%). They were divided into two groups: neoplastic pathology (10/220; 4.5%), and non-neoplastic but clinically significant pathology (61/220; 27.7%). The most common significant but non-neoplastic pathologies were angioectasias (22/61) and Crohn’s disease (15/61). On multivariate analysis, weight loss and lower mean corpuscular volume(MCV) were associated with significant SB pathology (OR: 3.87; 95%CI: 1.3–11.3; p = 0.01; and OR: 0.96; 95%CI: 0.92–0.99; p = 0.03; respectively). Our model also demonstrates association between use of antiplatelets and significant SB pathology, although due to the small number of patients, definitive conclusions cannot be drawn. Conclusion: In IDA patients ≤50 years with negative bidirectional GI endoscopy, overall DY of SBCE for clinically significant findings was 32.3%. Some 5% of our cohort was diagnosed with SB neoplasia; lower MCV or weight loss were associated with higher DY for SB pathology.
AB - Background: Recent data imply young patients (age ≤50 years) undergoing small-bowel (SB) capsule endoscopy (CE) for iron deficiency anaemia (IDA) show higher diagnostic yield (DY) for sinister pathology. We aimed to investigate DY of CE in a large cohort of young IDA patients, and evaluate factors predicting significant SB pathology. Materials and methods: This was a retrospective, multicentre study (2010–2015) in consecutive, young patients (≤50 years) from 18 centres/12 countries, with negative bidirectional gastrointestinal (GI) endoscopy undergoing SBCE for IDA. Exclusion criteria: previous/ongoing obscure-overt GI bleeding; age <19 or >50 years; comorbidities associated with IDA. Data retrieved: SBCE indications; prior investigations; medications; SBCE findings; final diagnosis. Clinical and laboratory data were analysed by multivariate logistic regression. Results: Data on 389 young IDA patients were retrieved. In total, 169 (43.4%) were excluded due to incomplete clinical data; data from 220 (122F/98M; mean age 40.5 ± 8.6 years) patients were analysed. Some 71 patients had at least one clinically significant SBCE finding (DY: 32.3%). They were divided into two groups: neoplastic pathology (10/220; 4.5%), and non-neoplastic but clinically significant pathology (61/220; 27.7%). The most common significant but non-neoplastic pathologies were angioectasias (22/61) and Crohn’s disease (15/61). On multivariate analysis, weight loss and lower mean corpuscular volume(MCV) were associated with significant SB pathology (OR: 3.87; 95%CI: 1.3–11.3; p = 0.01; and OR: 0.96; 95%CI: 0.92–0.99; p = 0.03; respectively). Our model also demonstrates association between use of antiplatelets and significant SB pathology, although due to the small number of patients, definitive conclusions cannot be drawn. Conclusion: In IDA patients ≤50 years with negative bidirectional GI endoscopy, overall DY of SBCE for clinically significant findings was 32.3%. Some 5% of our cohort was diagnosed with SB neoplasia; lower MCV or weight loss were associated with higher DY for SB pathology.
KW - Capsule endoscopy
KW - iron deficiency anaemia
KW - neoplasia
KW - small bowel
KW - young
UR - https://www.scopus.com/pages/publications/85032942077
U2 - 10.1177/2050640617692501
DO - 10.1177/2050640617692501
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C2 - 29163963
AN - SCOPUS:85032942077
SN - 2050-6406
VL - 5
SP - 974
EP - 981
JO - United European Gastroenterology Journal
JF - United European Gastroenterology Journal
IS - 7
ER -