Abstract:
BACKGROUND/AIMS:We evaluated the diagnostic variability and reproducibility of endoscopic signs in two populations with a different pretest likelihood of celiac disease (CD). METHODS:We recruited 289 CD patients (both adults and children) in a multicenter prospective study. Group 1 (high risk) included 111 patients referred for positive serology. Group 2 (low risk) included 178 unselected patients. Mosaic pattern, reduction/loss of Kerckring's folds, scalloping of the valvulae conniventes and a nodular pattern were the endoscopic findings looked for in the duodenum. RESULTS:In group 1, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of endoscopic findings were 100, 84.6, 94.2 and 100% in adults, and 86.8, 9.1, 82.1 and 12.5% in children. In group 2, the sensitivity, specificity, PPV and NPV of endoscopic findings were 33.3, 91.4, 7.7 and 98.5% in adults, and noncalculable, 78.3, 0.0 and 100% in children. Comparing group 1 and group 2, there was a statistically significant difference in sensitivity and PPV in adults, and in specificity, PPV and NPV in children. Concerning the reproducibility of endoscopic findings, a wide variability of κ values was found. CONCLUSION:Endoscopic signs have low reproducibility for CD, and their diagnostic value in selecting patients for multiple intestinal biopsies is unacceptable, especially in populations with low disease prevalence.
journal_name
Digestionjournal_title
Digestionauthors
Pellegrino S,Furfaro F,Tortora A,Naso P,D'Agate C,Spina M,Belluardo N,Bertone A,Passanisi G,Malandrino S,Familiari L,Villanacci V,Puzzo L,Tuccari G,Sciacca A,Vieni G,Costa S,Currò G,Magazzù G,Sferlazzas C,Bassottidoi
10.1159/000350436subject
Has Abstractpub_date
2013-01-01 00:00:00pages
254-61issue
4eissn
0012-2823issn
1421-9867pii
000350436journal_volume
87pub_type
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