Diagnostic Yield of Routine Duodenal Biopsies in Iron Deficiency Anemia for Celiac Disease Diagnosis. (20th February 2013)

• Record Type: Journal Article
• Authors: Chellat, Houria; Salihoun, Mouna; Kabbaj, Nawal; Amrani, Leila; Serraj, Ilham; Chaoui, Zakia; Nya, M'hamed; Acherki, Mohammed; Amrani, Naïma
• Other Names: Born P. Academic Editor.; Braden B. Academic Editor.; Sewitch M. Academic Editor.
• Is Part Of: ISRN endoscopy. Volume 2013(2013)
• Publication Date: 2013-02-20
• Subjects: Endoscopy -- Periodicals; 616.07545
• DOI: 10.5402/2013/769519
• Languages: English
• ISSNs: 2090-9411

Abstract

Abstract : Background . Iron deficiency anemia (IDA) is a recognised feature of celiac disease (CD) in adults and can be its only presentation. Aim . To define the prevalence of CD in Moroccan adult patients with IDA of obscure origin and to determine the yield of small bowel biopsy performed during routine endoscopy. Methods . 437 patients with IDA of obscure origin were included. 4 endoscopic mucosal biopsies were taken from the second part of duodenum and 2 biopsies from antrum and fundus, respectively. Endoscopic aspect and severity of anemia were correlated with histological diagnoses using coefficient Kappa. Results . 29 out of 437 patients (6.63%) had CD. Endoscopic aspect was normal in 66%, a mosaic pattern of mucosa in 17%, and scalloping of the small bowel folds in 17%. 12 patients had Marsh III, 8 had Marsh II, 6 had Marsh I, and 3 had Marsh IV lesions. There was no correlation between degree of anemia, endoscopic aspect, and severity of duodenal lesions( Kappa = − 0.167 ) . Conclusion . Routine duodenal biopsy gives an additional 6.63% diagnostic benefit of CD and should be indicated in all patients with IDA. The finding of normal endoscopic appearance of mucosa should not preclude duodenal biopsies.