Περίληψη:
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.
Συγγραφείς:
Yung, D.E.
Rondonotti, E.
Giannakou, A.
Avni, T.
Rosa, B.
Toth, E.
Lucendo, A.J.
Sidhu, R.
Beaumont, H.
Ellul, P.
Negreanu, L.
Jiménez-Garcia, V.A.
McNamara, D.
Kopylov, U.
Elli, L.
Triantafyllou, K.
Shibli, F.
Riccioni, M.E.
Bruno, M.
Dray, X.
Plevris, J.N.
Koulaouzidis, A.
And the Capsule Endoscopy in Young Patients with IDA research group
Argüelles-Arias, F.
Becq, A.
Branchi, F.
Tejero-Bustos, M.Á.
Cotter, J.
Eliakim, R.
Ferretti, F.
Gralnek, I.M.
Herrerias-Gutierrez, J.M.
Hussey, M.
Jacobs, M.
Johansson, G.W.
McAlindon, M.
Montiero, S.
Nemeth, A.
Pennazio, M.
Rattehalli, D.
Stemate, A.
Tortora, A.
Tziatzios, G.
Λέξεις-κλειδιά:
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
