Role of capsule endoscopy in suspected celiac disease: A European multi-centre study

Table 1 Diagnostic performance of capsule endoscopy for the subgroups

Subgroup (n, %yield)1	Normal	Intestinal atrophy	Complicated CD	Other enteropathies
I (n = 14/19, 73.7%)	5 (26.3)	9 (47.4)	5 (26.3)	0
II (n = 27/39, 69.2%)	12 (30.8)	25 (64.1)	1 (2.6)	1 (2.6)
III (n = 3/6, 50%)	3 (50.0)	3 (50.0)	0	0
IV (n = 44/99, 44.4%)	55 (55.6)	28 (28.3)	6 (6.1)	10 (10.1)

¹Group-I: Seronegative celiac disease; Group-II: Positive serology with no atrophy; Group-III: Contraindications or refusal to undergo gastroscopy; Group-IV: Seronegative patients without atrophy, with clinical digestive symptoms and/or anaemia. CD: Celiac disease.

Table 2 Comparison of capsule endoscopy results with a subsequent histology evaluation of the same patient

CE diagnostic yield	Biopsied cases	Biopsy result	Agreement
Normal	n = 2	Normal (n = 2)	100%
Atrophy	n = 10	Normal (n = 2), atrophy (n = 7)2, lymphoma (n = 1)	70%
Complicated CD1	n = 4	Atrophy (n = 2), UJ (n = 2)	50%
Other diagnoses	n = 3	Crohn’s disease (n = 2),	100%
		Ulcerative colitis (n = 1)

¹Three ulcerative jejunoileitis (UJ) and one lymphoma;

²One of the biopsies reported Marsh III and eosinophilic gastroenteropathy. CE: Capsule endoscopy; CD: Celiac disease.

Table 3 Modifications and response to the gluten-free diet in the different subgroups of patients n (%)

Subgroup1	Therapeutic yield	GFD Indicated	GFD removed	Responded to GFD	Responded to the withdrawal
I (n =19)	16 (84.2)	12 (63.2)	1 (5.3)	8 (66.7)	0
II (n = 39)	31 (79.5)	27 (69.2)	0	18 (66.7)	-
III (n = 6)	6 (100)	5 (83.3)	0	4 (80)	-
IV (n = 99)	64 (64.7)	41 (41.4)	3 (3.1)	39 (95.1)	3 (100)

¹Group-I: seronegative celiac disease; Group-II: Positive serology with no atrophy; Group-III: Contraindications or refusal to undergo gastroscopy; Group-IV: Seronegative patients without atrophy, with clinical digestive symptoms and/or anaemia. GFD: Gluten-free diet.