@article{3108184,
    title = "Capsule endoscopy in young patients with iron deficiency anaemia and negative bidirectional gastrointestinal endoscopy",
    author = "Yung, D.E. and Rondonotti, E. and Giannakou, A. and Avni, T. and Rosa, B. and Toth, E. and Lucendo, A.J. and Sidhu, R. and Beaumont, H. and Ellul, P. and Negreanu, L. and Jiménez-Garcia, V.A. and McNamara, D. and Kopylov, U. and Elli, L. and Triantafyllou, K. and Shibli, F. and Riccioni, M.E. and Bruno, M. and Dray, X. and Plevris, J.N. and Koulaouzidis, A. and And the Capsule Endoscopy in Young Patients with IDA research group and Argüelles-Arias, F. and Becq, A. and Branchi, F. and Tejero-Bustos, M.Á. and Cotter, J. and Eliakim, R. and Ferretti, F. and Gralnek, I.M. and Herrerias-Gutierrez, J.M. and Hussey, M. and Jacobs, M. and Johansson, G.W. and McAlindon, M. and Montiero, S. and Nemeth, A. and Pennazio, M. and Rattehalli, D. and Stemate, A. and Tortora, A. and Tziatzios, G.",
    journal = "United European Gastroenterology Journal",
    year = "2017",
    volume = "5",
    number = "7",
    pages = "974-981",
    publisher = "SAGE Publications Ltd",
    issn = "2050-6406, 2050-6414",
    doi = "10.1177/2050640617692501",
    keywords = "antithrombocytic agent;  ferritin;  hemoglobin, adult;  angioectasias;  Article;  capsule endoscopy;  controlled study;  Crohn disease;  female;  gastrointestinal endoscopy;  human;  iron deficiency anemia;  major clinical study;  male;  mean corpuscular volume;  multicenter study;  neoplasm;  priority journal;  questionnaire;  retrospective study;  weight reduction",
    abstract = "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. © 2017, © Author(s) 2017."
}