TY - JOUR
TI - Capsule endoscopy in young patients with iron deficiency anaemia and negative bidirectional gastrointestinal endoscopy
AU - Yung, D.E.
AU - Rondonotti, E.
AU - Giannakou, A.
AU - Avni, T.
AU - Rosa, B.
AU - Toth, E.
AU - Lucendo, A.J.
AU - Sidhu, R.
AU - Beaumont, H.
AU - Ellul, P.
AU - Negreanu, L.
AU - Jiménez-Garcia, V.A.
AU - McNamara, D.
AU - Kopylov, U.
AU - Elli, L.
AU - Triantafyllou, K.
AU - Shibli, F.
AU - Riccioni, M.E.
AU - Bruno, M.
AU - Dray, X.
AU - Plevris, J.N.
AU - Koulaouzidis, A.
AU - And the Capsule Endoscopy in Young Patients with IDA research group
AU - Argüelles-Arias, F.
AU - Becq, A.
AU - Branchi, F.
AU - Tejero-Bustos, M.Á.
AU - Cotter, J.
AU - Eliakim, R.
AU - Ferretti, F.
AU - Gralnek, I.M.
AU - Herrerias-Gutierrez, J.M.
AU - Hussey, M.
AU - Jacobs, M.
AU - Johansson, G.W.
AU - McAlindon, M.
AU - Montiero, S.
AU - Nemeth, A.
AU - Pennazio, M.
AU - Rattehalli, D.
AU - Stemate, A.
AU - Tortora, A.
AU - Tziatzios, G.
JO - United European Gastroenterology Journal
PY - 2017
VL - 5
TODO - 7
SP - 974-981
PB - SAGE Publications Ltd
SN - 2050-6406, 2050-6414
TODO - 10.1177/2050640617692501
TODO - 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
TODO - 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.
ER -