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Title: | Anti-endomysial antibody may predict a second endoscopy in coeliac-suspected patients with false negative index duodenal biopsies |
Authors: | Gerada, Jurgen Gerada, Eleanor Grech, Gabriella Ellul, Pierre |
Keywords: | Celiac disease -- Diagnosis Celiac disease -- Patients -- Malta -- Case studies Intestine, Small -- Biopsy |
Issue Date: | 2015 |
Publisher: | Austin Publishing Group |
Citation: | Gerada, J., Gerada, E., Abdilla, S., Grech, G., & Ellul, P. (2015). Anti-Endomysial Antibody May Predict a Second Endoscopy in Coeliac-Suspected Patients with False Negative Index Duodenal Biopsies. Austin Journal of Gastroenterology, 2(1), 1029. |
Abstract: | Background/aims: A subset of coeliac-suspected patients requires 2
Oesophagogastroduodenoscopies (OGDs) to achieve histological confirmation.
Their index OGD would fail to reach diagnosis despite 4 duodenal biopsies
suggested by guidelines. We compared this subgroup of patients with other
coeliac patients requiring 1 endoscopy and recognize any predictors to identify
the former group. Methods: Coeliac-suspected patients at our department underwent an OGD. Clinical, serological and histological data were retrieved from medical notes. Group 1 comprised patients who achieved diagnosis with 1 OGD. Group 2 required 2 OGDs. Results: 178 patients underwent an OGD (mean age 47 years; 73.6% females). 12 patients (6.7%) required 2 OGDs. Both groups had the same mean number of duodenal biopsies at their index endoscopy (4.6 vs 4.5, P=0.76). In Group 2, the number of biopsies was higher at the second endoscopy (6.4 vs 4.5, P=0.028). Group 2 showed a negative or lower positivity for anti-EMA (P=0.039) and a lower anti-tTG IgA level (P=0.06) than Group 1. Conclusion: Anti-EMA seronegativity or low positivity in coeliac-suspected patients indicates the need for more duodenal biopsies to achieve diagnosis and avoiding subsequent OGDs. This finding makes anti-EMA testing crucial in coeliac diagnostics. |
URI: | https://www.um.edu.mt/library/oar/handle/123456789/103734 |
ISSN: | 23819219 |
Appears in Collections: | Scholarly Works - FacM&SMed |
Files in This Item:
File | Description | Size | Format | |
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Anti endomysial antibody may predict a second endoscopy in coeliac suspected patients with false negative index duodenal biopsies 2015.pdf | 1.53 MB | Adobe PDF | View/Open |
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