Prevalence of celiac disease in adult patients with refractory functional dyspepsia： Value of routine duodenal biopsy

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.

Prevalence of celiac disease in adult patients with refractory functional dyspepsia:Value of routine duodenal biopsy

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.