Systematic review and meta-analysisUse of enteroscopy for the detection of malignant and premalignant lesions of the small bowel in complicated celiac disease: a meta-analysis
Section snippets
Protocol and criteria applied
The Preferred Reporting System for Systematic Reviews and Meta-Analyses was used as a guideline. The inclusion criteria for article types were prospective or retrospective, observational or comparative studies in which enteroscopic techniques were performed with the intention to detect any possible adverse event in CD patients with a complicated course. Case reports, congress reports, commentaries, editorials, and review articles were excluded from the analysis. Also, any study planned for the
Results
The literature search initially returned 529 studies from the CE search strategy and 183 from the wired enteroscopy strategy. Of all, 10 studies for CE11, 12, 14, 15, 16, 18, 19, 20, 22, 23 and 3 for wired enteroscopy13, 17, 21 met the inclusion criteria and were eligible for meta-analysis. No cases of discordance occurred among the 3 reviewers. Figure 1 reports the literature search flowcharts. Tables 1 and 2 report the clinical and demographic characteristics of the analyzed 10 CE and 3 wired
Discussion
To the best of our knowledge, this is the first meta-analysis to investigate the use of enteroscopy as a screening tool for the detection of SB malignant and premalignant lesions in the “complicated CD” scenario. From the present meta-analysis, enteroscopy has resulted in a DY of about 20% for malignancies and premalignant lesions originating from the SB mucosal layer. This is highly important for patient prognosis and management, because the diagnosis of EATL, SB adenocarcinoma, or UJ implies
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Clinical features of type 1 and 2 refractory celiac disease: Results from a large cohort over a decade
2023, Digestive and Liver DiseaseCitation Excerpt :Furthermore, a statistically significant correlation between mortality and disease extent was observed in patients with RCeD-II. These data confirmed the importance of CE in the staging and follow-up of patients in both groups [20,24–26]. In fact, CE could be used to evaluate the disease extension and drive a rapid therapeutic decision/modification.
Effectiveness of Capsule Endoscopy and Double-Balloon Enteroscopy in Suspected Complicated Celiac Disease
2022, Clinical Gastroenterology and HepatologyCitation Excerpt :We also found that CE and DBE greatly improved the endoscopic DY for CD complications and these tests were valuable tools for managing symptomatic or at-risk CD patients.18 Our results show that a sequential CE-DBE approach is effective and should be considered as the first-line approach to assess at-risk patients and detect CD-related complications.13 Luca Elli, PhD, MD (Conceptualization: Lead; Data curation: Lead; Formal analysis: Equal; Investigation: Lead; Project administration: Lead; Writing – original draft: Lead; Writing – review & editing: Lead)
Video capsule endoscopy
2021, Gastrointestinal EndoscopyCitation Excerpt :The frequency of villous atrophy was not different between the refractory and asymptomatic patients, and mucosal erosions were seen in all 3 groups with similar frequency.73-75 In a meta-analysis involving 10 studies and 439 patients with refractory celiac disease, the diagnostic yield of VCE for either ulcerative jejunitis or neoplasia was 13% (95% CI, 5.6-22.5).76 In a retrospective multicenter study involving 189 patients with either refractory celiac disease or alarm features, VCE detected ulcerative jejunitis or neoplasia in 29 patients (15.3%).77
Comorbidities associated with celiac disease, dermatitis herpetiformis, and nonceliac gluten sensitivity
2021, Gluten-Related Disorders: Diagnostic Approaches, Treatment Pathways, and Future PerspectivesCellular and molecular bases of refractory celiac disease
2021, International Review of Cell and Molecular BiologyCitation Excerpt :On endoscopy, mucosal damage extending beyond the proximal small bowel and multiple ulcers are commonly observed in RCD; the presence of erosions, strictures, and large ulcers (>1 cm) is more common in RCD II (Ashton-Key et al., 1997; Bagdi et al., 1999; Cellier et al., 2000; Malamut et al., 2009). If ulcerations, strictures, or masses are observed, device-assisted enteroscopy (DAE) is recommend for further exploration (Branchi et al., 2016; Elli et al., 2017). Up to 70% of RCD patients show MRI abnormalities, which include jejunoileal fold reversal, small bowel wall thickening or dilation, and splenic atrophy (volume <100 cm3) (Al-Bawardy et al., 2017; Radmard et al., 2017; van Gils et al., 2017).
DISCLOSURE: All authors disclosed no financial relationships relevant to this publication. Research support for this study was provided in part by grants from Fondazione IRCCS Ca’ Granda (affiliations 1 and 2), research support was provided by grants from the Italian Ministry of Health and Lumbardy's Regional Government Authority (Ministero della Salute e Regione Lombardia call no. 2011-02348234).
If you would like to chat with an author of this article, you may contact Dr Elli at [email protected].