Capsule endoscopy in young patients with iron deficiency anaemia and negative bidirectional gastrointestinal endoscopy

And the Capsule Endoscopy in Young Patients with IDA research group, Diana E Yung, Emanuele Rondonotti, Andry Giannakou, Tomer Avni, Bruno Rosa, Ervin Toth, Alfredo J Lucendo, Reena Sidhu, Hanneke Beaumont, Pierre Ellul, Lucian Negreanu, Victoria Alejandra Jiménez-Garcia, Deidre McNamara, Uri Kopylov, Luca Elli, Konstantinos Triantafyllou, Fahmi Shibli, Maria Elena Riccioni, Mauro BrunoXavier Dray, John N Plevris, A Koulaouzidis, Federico Argüelles-Arias, Aymeric Becq, Federica Branchi, María Ángeles Tejero-Bustos, Jose Cotter, Rami Eliakim, Francesca Ferretti, Ian M Gralnek, Juan Manuel Herrerias-Gutierrez, Mary Hussey, Maarten Jacobs, Gabriele Wurm Johansson, Mark McAlindon, Sara Montiero, Artur Nemeth, Marco Pennazio, Deepa Rattehalli, Ana Stemate, Annalisa Tortora, Georgios Tziatzios

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)974-981
Number of pages8
JournalUnited European Gastroenterology Journal
Volume5
Issue number7
Early online date1 Feb 2017
DOIs
Publication statusPublished - Nov 2017

Keywords

  • Journal Article

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