Evaluation of endoscopic versus serologic and histopathologic changes in the diagnosis of celiac disease

الملخص EN

Objectives : To evaluate the endoscopic versus serologic and histopathologic changes in the diagnosis of celiac disease and to correlate the endoscopic changes with the degree of mucosal damage. Methods: Seventy two patients with symptoms of chronic diarrhea, 38 females whose ages ranged from 11 to 60 years and 34 males whose ages ranged from 10 - 59 years were tested for anti-tissue transglutaminase after they underwent upper gastroduodenoscopy.

Duodenal mucosa was visualized carefully for any changes of celiac disease.

Four endoscopic biopsies were taken from each patient and sent for histopathologic examination.Duodenal biopsies were classified according to modified Marsh’s classification. Results: Among the 72 patients who were enrolled in the study, 28 patients tested positive for anti tissue transglutaminase, 47 patients had histopathologic changes, 26 patients who had both anti tissue transglutaminase and histopathologic changes were classified as celiac patients, among them 19 patients had endoscopic changes.

The sensititvity, specificity, positive predictive value and negative predictive value of endoscopic changes were (73.07%), (86.95%), (76%), and (85.1%), respectively. Conclusions: The endoscopic appearance of the duodenum may be predictive of the severity of mucosal damage; but overall, the endoscopic changes have a wide range of sensitivity because the endoscopic findings had been normal in the presence of minor mucosal changes.

Anti tissue transglutaminase was well correlated with histopatholgic changes in celiac disease.