Giangreco E, D’agate C, Barbera C, Puzzo L, Aprile G, Naso P, Bonanno G, Russo FP, Nicoletti A, Incarbone S, Trama G, Russo A. Prevalence of celiac disease in adult patients with refractory functional dyspepsia: Value of routine duodenal biopsy. World J Gastroenterol 2008; 14(45): 6948-6953 [PMID: 19058330 DOI: 10.3748/wjg.14.6948]
Corresponding Author of This Article
Antonio Russo, Professor, Cattedra di Gastroenterologia, Azienda Ospedaliero Univeristaria Policlinico Catania, Via Santa Sofia 78, Catania 95125, Italy. arussombox@unict.it
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World J Gastroenterol. Dec 7, 2008; 14(45): 6948-6953 Published online Dec 7, 2008. doi: 10.3748/wjg.14.6948
Prevalence of celiac disease in adult patients with refractory functional dyspepsia: Value of routine duodenal biopsy
Emiliano Giangreco, Cinzia D’agate, Carmelo Barbera, Lidia Puzzo, Giuseppe Aprile, Pietro Naso, Giacomo Bonanno, Francesco Paolo Russo, Alessandra Nicoletti, Salvatore Incarbone, Giuseppe Trama, Antonio Russo
Emiliano Giangreco, Cinzia D’agate, Carmelo Barbera, Lidia Puzzo, Giuseppe Aprile, Pietro Naso, Giacomo Bonanno, Alessandra Nicoletti, Salvatore Incarbone, Giuseppe Trama, Antonio Russo, Department of Surgery, Gastroenterology and Endoscopy Unit, University of Catania, Via Santa Sofia 78, Catania 95125, Italy
Francesco Paolo Russo, Department of Surgical and Gastro-enterological Sciences, Gastroenterology Section, University of Padova, Via Giustiniani 2, Padova 35100, Italy
Author contributions: Giangreco E, D’agate C, Barbera C, Puzzo L, Aprile G, Naso P, Bonanno G, Russo FP, Nicoletti A, Incarbone S, Trama G and Russo A performed the research; Russo FP edited the paper.
Correspondence to: Antonio Russo, Professor, Cattedra di Gastroenterologia, Azienda Ospedaliero Univeristaria Policlinico Catania, Via Santa Sofia 78, Catania 95125, Italy. arussombox@unict.it
Telephone: +39-95-3782337 Fax: +39-95-337065
Received: April 23, 2008 Revised: November 18, 2008 Accepted: November 25, 2008 Published online: December 7, 2008
Abstract
AIM: To investigate the prevalence of celiac disease (CD) in adult patients referred to an open access gastroenterology clinic in the south of Italy and submitted to esophago-gastro-duodenoscopy (EGD) for evaluation of refractory functional dyspepsia.
METHODS: Seven hundred and twenty six consecutive dyspeptic patients (282 male, 444 female; mean age 39.6 years, range 18-75 years) with unexplained prolonged dyspepsia were prospectively enrolled. Duodenal biopsies were taken and processed by standard staining. Histological evaluation was carried out according to the Marsh-Oberhuber criteria.
RESULTS: The endoscopic findings were: normal in 61.2%, peptic lesions in 20.5%, malignancies in 0.5%, miscellaneous in 16.7%. CD was endoscopically diagnosed in 8 patients (1.1%), histologically in 15 patients (2%). The endoscopic features alone showed a sensitivity of 34.8% and specificity of 100%, with a positive predictive value (PPV) of 100% and a negative predictive value (NPP) of 97.9%.
CONCLUSION: This prospective study showed that CD has a high prevalence (1:48) in adult dyspeptic patients and suggests the routine use of duodenal biopsy in this type of patient undergoing EGD.
