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Revista Uruguaya de Medicina Interna

Print version ISSN 2393-6797On-line version ISSN 2393-6797

Abstract

RODRIGUEZ OLASO, Ximena; OLANO GOSSWEILER, Carolina  and  LOPEZ GONZALEZ, Virginia. Use of new techniques and endoscopic procedures in the diagnosis and monitoring of celiac disease. Rev. Urug. Med. Int. [online]. 2018, vol.3, n.1, pp.3-14. ISSN 2393-6797.  http://dx.doi.org/10.26445/rmu.3.1.1.

Since endoscopic methods are used for biopsying the duodenum at diagnosis or follow-up in celiac disease, attempts have been made to find macroscopically visible markers that suggest or confirm the presence of villous atrophy in the studied area. Some of these signs are highly specific but their sensitivity is low so that, if alone, they have little value in the diagnostic algorithm. The objective of this review is to analyze the existing scientific evidence on the usefulness of new technologies and endoscopic techniques in the identification of markers of villous atrophy in the diagnosis and follow-up of celiac disease. Method. A descriptive review of literature was conducted, where original articles were sought in Pubmed and LILACS databases in the period 2006-2016. Results. The value of digital chromoendoscopy for the search of endoscopic markers of villous atrophy has barely been studied. Sensitivity of NBI with magnification is estimated between 83 and 95%. The only studies with OBI and I-Scan showed perfect specificity and sensitivity, but only in patients with high probability of being celiac or with severe atrophy. Regarding endoscopic microscopy, endocytoscopy does not seem to improve performance in a significant way, however, with only two studies with a small number of patients, confocal laser endomicroscopy has shown greater sensitivity in the detection of atrophy markers. The VCE has high specificity (100%) but low sensitivity and its greatest utility is finding alterations that are beyond the scope of traditional endoscopy and assess its extent. There are no studies that specifically evaluate the presence of the same signs with double balloon enteroscopy, single balloon or spiral. Conclusions. Some of the new techniques and technologies appear to be highly specific but less sensitive in the detection of endoscopic markers of villous atrophy. More studies are needed to determine the value of endoscopic microscopy techniques as a diagnostic tool in the future.

Keywords : endoscopy; celiac disease; villous atrophy; videocapsule endoscopy.

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