+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

A second duodenal biopsy is necessary in the follow-up of adult coeliac patients



A second duodenal biopsy is necessary in the follow-up of adult coeliac patients



Annals of Medicine 46(6): 430-433



Coeliac disease is a chronic enteropathy requiring a close follow-up. However, the best way to follow up coeliac patients has not yet been established. In the last 14 years, we have been offering patients a thorough series of periodical examinations including a histological re-evaluation at 12-18 months. The notes of all coeliac patients attending our clinic between September 1999 and March 2013 were examined. Data from 317 adult patients were collected. Duodenal biopsy showed a lack of satisfactory histological response in 25/317 patients; endomysial antibodies were still positive in 76, and diet adherence and clinical response were unsatisfactory in 58 and 97, respectively. Correlations of serological data, clinical response, and diet adherence with histological findings were evaluated. Although the P values showed statistically significant differences, sensitivity and specificity were disappointing: 64% and 80% for serological response, 48% and 71% for clinical response, 56% and 85% for diet adherence. After 12-18 months on a gluten-free diet, 8% of the patients do not present a satisfactory histological response; only some of them could have been identified with a serological and/or clinical re-evaluation. Therefore, a duodenal biopsy seems to be the only tool that could identify patients with unsatisfactory histological response.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 051248071

Download citation: RISBibTeXText

PMID: 24857202

DOI: 10.3109/07853890.2014.913378


Related references

Pwe-117Responses to dietary intervention guided by follow-up duodenal biopsy in coeliac disease. Gut 61(Suppl 2): A344.2-A344, 2012

The role of the duodenal perendoscopic biopsy in the adult coeliac disease. Acta Endoscopica 22(2): 153-158, 1992

Value of routine duodenal biopsy in diagnosing coeliac disease in patients with iron deficiency anaemia. Postgraduate Medical Journal 80(946): 475-477, 2004

The presence of anti-endomysial antibodies and the level of anti-tissue transglutaminases can be used to diagnose adult coeliac disease without duodenal biopsy. Alimentary Pharmacology and Therapeutics 40(10): 1223-1229, 2014

Histological evaluation of duodenal biopsies from coeliac patients: the need for different grading criteria during follow-up. Bmc Gastroenterology 15: 133, 2015

Review of Ttg Versus Small Intestinal Biopsy Results; Do We Still Need Duodenal Biopsy to Diagnose Coeliac Disease?. Archives of Disease in Childhood 97(Suppl 2): A208-A209, 2012

OC-081Can a risk of coeliac disease scoring system reduce the number of patients referred for duodenal biopsy?. Gut 59(Suppl 1): A33.3-A34, 2010

Seronegative coeliac disease: Are they coeliac? When biopsy in adult can be avoided?. Gastroenterology and Hepatology from Bed to Bench 11(3): 178-180, 2018

PTH-184Push Enteroscopy Leads to a Change in Diagnosis in the Majority of Patients with Positive Coeliac Serology and Negative Duodenal Biopsy. Gut 62(Suppl 1): A286.1-A286, 2013

M1224 Routine Duodenal Biopsy Is a Cost-Effective Way to Increase the Yield of Diagnosing Coeliac Disease in Patients Undergoing Upper Gastrointestinal Endoscopy. Gastroenterology 134(4): A-364-A-365, 2008

Enzyme Activities in Jejunal Biopsy Samples from Patients with Adult Coeliac Disease with and without Steatorrhoea. Scandinavian Journal of Gastroenterology 18(3): 365-368, 1983

Pre-endoscopic serological test with duodenal biopsy in high risk patients had high sensitivity and low specificity for coeliac disease. Evidence-BasedMedicine12(5):155, 2007

Random duodenal biopsy to exclude coeliac disease as a cause of anaemia is not cost-efective and should be replaced with universally performed pre-endoscopy serology in patients on a suspected cancer pathway. Techniques in Coloproctology 22(2): 121-124, 2018

A no biopsy strategy for adult patients with suspected coeliac disease: making the world gluten-free. Gut 64(6): 1003-1004, 2015

The value of duodenal biopsy in the diagnosis of coeliac disease. Schweizerische Rundschau für Medizin Praxis 70(34): 1477-1480, 1981