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Title: Capsule endoscopy in young patients with iron deficiency anaemia and negative bidirectional gastrointestinal endoscopy.
Authors: Yung, Diana E
Rondonotti, Emanuele
Giannakou, Andry
Avni, Tomer
Rosa, Bruno
Toth, Ervin
Lucendo, Alfredo J
Sidhu, Reena
Beaumont, Hanneke
Ellul, Pierre
Negreanu, Lucian
Jiménez-Garcia, Victoria Alejandra
McNamara, Deidre
Kopylov, Uri
Elli, Luca
Triantafyllou, Konstantinos
Shibli, Fahmi
Riccioni, Maria Elena
Bruno, Mauro
Dray, Xavier
Plevris, John N
Koulaouzidis, A
And the Capsule Endoscopy in Young Patients with IDA research group
Argüelles-Arias, Federico
Becq, Aymeric
Branchi, Federica
Tejero-Bustos, María Ángeles
Cotter, Jose
Eliakim, Rami
Ferretti, Francesca
Gralnek, Ian M
Herrerias-Gutierrez, Juan Manuel
Hussey, Mary
Jacobs, Maarten
Johansson, Gabriele Wurm
McAlindon, Mark
Montiero, Sara
Nemeth, Artur
Pennazio, Marco
Rattehalli, Deepa
Stemate, Ana
Tortora, Annalisa
Tziatzios, Georgios
Keywords: Capsule endoscopy;iron deficiency anaemia;neoplasia;small bowel;young
Issue Date: 1-Feb-2017
Abstract: 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. 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 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. 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. 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.
metadata.dc.identifier.doi: 10.1177/2050640617692501
ISSN: 2050-6406
Appears in Collections:Producción 2020

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