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 Bruno; Xavier 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

doi:10.1177/2050640617692501

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

Deanery of Clinical Sciences

Research output: Contribution to journal › Article › peer-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 language	English
Pages (from-to)	974-981
Number of pages	8
Journal	United European Gastroenterology Journal
Volume	5
Issue number	7
Early online date	1 Feb 2017
DOIs	https://doi.org/10.1177/2050640617692501
Publication status	Published - Nov 2017

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Journal Article

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10.1177/2050640617692501

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And the Capsule Endoscopy in Young Patients with IDA research group, Yung, D. E., Rondonotti, E., Giannakou, A., Avni, T., Rosa, B., Toth, E., Lucendo, A. J., Sidhu, R., Beaumont, H., Ellul, P., Negreanu, L., Jiménez-Garcia, V. A., McNamara, D., Kopylov, U., Elli, L., Triantafyllou, K., Shibli, F., Riccioni, M. E., ... Tziatzios, G. (2017). Capsule endoscopy in young patients with iron deficiency anaemia and negative bidirectional gastrointestinal endoscopy. United European Gastroenterology Journal, 5(7), 974-981. https://doi.org/10.1177/2050640617692501

@article{6c31f84a0582425dae0e22909eba1cca,

title = "Capsule endoscopy in young patients with iron deficiency anaemia and negative bidirectional gastrointestinal endoscopy",

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.",

keywords = "Journal Article",

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

year = "2017",

month = nov,

doi = "10.1177/2050640617692501",

language = "English",

volume = "5",

pages = "974--981",

journal = "United European Gastroenterology Journal",

issn = "2050-6406",

publisher = "SAGE Publications",

number = "7",

}

And the Capsule Endoscopy in Young Patients with IDA research group, Yung, DE, Rondonotti, E, Giannakou, A, Avni, T, Rosa, B, Toth, E, Lucendo, AJ, Sidhu, R, Beaumont, H, Ellul, P, Negreanu, L, Jiménez-Garcia, VA, McNamara, D, Kopylov, U, Elli, L, Triantafyllou, K, Shibli, F, Riccioni, ME, Bruno, M, Dray, X, Plevris, JN, Koulaouzidis, A, Argüelles-Arias, F, Becq, A, Branchi, F, Tejero-Bustos, MÁ, Cotter, J, Eliakim, R, Ferretti, F, Gralnek, IM, Herrerias-Gutierrez, JM, Hussey, M, Jacobs, M, Johansson, GW, McAlindon, M, Montiero, S, Nemeth, A, Pennazio, M, Rattehalli, D, Stemate, A, Tortora, A & Tziatzios, G 2017, 'Capsule endoscopy in young patients with iron deficiency anaemia and negative bidirectional gastrointestinal endoscopy', United European Gastroenterology Journal, vol. 5, no. 7, pp. 974-981. https://doi.org/10.1177/2050640617692501

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; Yung, Diana E; Rondonotti, Emanuele et al.
In: United European Gastroenterology Journal, Vol. 5, No. 7, 11.2017, p. 974-981.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Capsule endoscopy in young patients with iron deficiency anaemia and negative bidirectional gastrointestinal endoscopy

AU - And the Capsule Endoscopy in Young Patients with IDA research group

AU - Yung, Diana E

AU - Rondonotti, Emanuele

AU - Giannakou, Andry

AU - Avni, Tomer

AU - Rosa, Bruno

AU - Toth, Ervin

AU - Lucendo, Alfredo J

AU - Sidhu, Reena

AU - Beaumont, Hanneke

AU - Ellul, Pierre

AU - Negreanu, Lucian

AU - Jiménez-Garcia, Victoria Alejandra

AU - McNamara, Deidre

AU - Kopylov, Uri

AU - Elli, Luca

AU - Triantafyllou, Konstantinos

AU - Shibli, Fahmi

AU - Riccioni, Maria Elena

AU - Bruno, Mauro

AU - Dray, Xavier

AU - Plevris, John N

AU - Koulaouzidis, A

AU - Argüelles-Arias, Federico

AU - Becq, Aymeric

AU - Branchi, Federica

AU - Tejero-Bustos, María Ángeles

AU - Cotter, Jose

AU - Eliakim, Rami

AU - Ferretti, Francesca

AU - Gralnek, Ian M

AU - Herrerias-Gutierrez, Juan Manuel

AU - Hussey, Mary

AU - Jacobs, Maarten

AU - Johansson, Gabriele Wurm

AU - McAlindon, Mark

AU - Montiero, Sara

AU - Nemeth, Artur

AU - Pennazio, Marco

AU - Rattehalli, Deepa

AU - Stemate, Ana

AU - Tortora, Annalisa

AU - Tziatzios, Georgios

PY - 2017/11

Y1 - 2017/11

N2 - 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.

AB - 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.

KW - Journal Article

U2 - 10.1177/2050640617692501

DO - 10.1177/2050640617692501

M3 - Article

C2 - 29163963

SN - 2050-6406

VL - 5

SP - 974

EP - 981

JO - United European Gastroenterology Journal

JF - United European Gastroenterology Journal

IS - 7

ER -

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

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