Original articleClinical endoscopyEndocytoscopy for the detection of microstructural features in adult patients with celiac sprue: a prospective, blinded endocytoscopy-conventional histology correlation study
Section snippets
Patients
We enrolled 40 consecutive adult patients with known CD (N = 32) with either clinically well-controlled (n = 29) or refractory (n = 3) disease or clinical and/or laboratory findings suggestive of CD (n= 8) between May 2006 and April 2007. The study was approved by the Ethics Committee of Charité Medical School (EA2/179/0).
EC procedure
The endocytoscope (Olympus Europe, Hamburg, Germany) used has a 3.4-mm outer diameter and can be passed through the working channel of a therapeutic endoscope mounted with a
Results
Patient demographics and details of histological classification of biopsy sites are shown in Table 2. Thirty-two patients had established CD. In 2 of the remaining 8 patients, CD was eventually established. The other 6 patients served as controls. In individual patients, all biopsy specimens showed the same Marsh classification except for 6 (15%) with patchy distribution. Table 3 shows the image quality of the individual EC recordings with respect to general assessment and evaluation of the
Discussion
Over the past 10 years, a number of enhancements of conventional high-resolution video endoscopy, by using water immersion for magnification, true magnification, staining, water immersion, or image processing techniques, have been evaluated. Reported sensitivity and specificity varied between 58% and 100% and 88% and 100%, respectively.20, 21, 22, 23, 24, 25, 26, 27 The accuracy of these enhanced techniques seemed promising, but methodological flaws (very high pretest probability and studying
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2014, Journal of Crohn's and ColitisCitation Excerpt :The technique was shown to be reliable for the examination of gastrointestinal mucosal surfaces.76–78 In addition, EC could predict neoplasia in aberrant crypt foci and could distinguish neoplastic from non-neoplasic colorectal lesions.78,79 Our group has recently assessed the value of EC to determine single inflammatory cells in patients with IBD.80
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2012, Best Practice and Research: Clinical GastroenterologyCitation Excerpt :This preliminary study shows that endocytoscopy allows in vivo, real-time, noninvasive visualisation and characterisation of villous architecture and may be a promising method for in vivo evaluation of duodenal mucosa in celiac disease [15]. In another study evaluating the usefulness of endocytoscopy for the diagnosis of celaic disease Heiko Pohl et al prospectively studied 166 endocytoscopy recordings of forty patients with established (n = 32) or suspected (n = 8) celiac disease [16]. Of the 166 duodenal biopsy sites, 23% were classified as Marsh III (moderate to severe), 10% as Marsh I (mild), and 67% as Marsh 0 (normal).
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DISCLOSURE: All authors disclosed no financial relationships relevant to this publication.
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