Celiac.com Sponsor (A1):



Celiac.com Sponsor (A1):


  • Join Our Community!

    Get help in our celiac / gluten-free forum.

  • Jefferson Adams

    Endoscopic Biopsy Technique in the Diagnosis of Celiac Disease: One Bite or Two?

    Jefferson Adams
    0
    Reviewed and edited by a celiac disease expert.   eNewsletter: Get our eNewsletter

    Celiac.com 03/18/2015 - Getting high-quality biopsy specimens is key to making accurate celiac disease diagnoses. Endoscopists may take either a single- or double-biopsy specimen with each pass of the forceps.

    Photo: CC--LabomikroDoes it matter whether they take one or two? Is two better than one?



    Celiac.com Sponsor (A12):




    A team of researchers recently set out to answer those questions, by comparing the quality of biopsy specimens obtained with the single-biopsy and double-biopsy techniques.

    The research team includes M. Latorre, S.M. Lagana, D.E. Freedberg, S.K. Lewis, B. Lebwohl, G. Bhagat, and P. H. Green of the Celiac Disease Center, Department of Medicine, Columbia University, New York, New York, USA.

    Their prospective cohort study looked at patients undergoing upper endoscopy with confirmed, suspected, or unknown celiac disease status. A total of 86 patients enrolled in the study, 47% with known celiac disease, 36% with suspected celiac disease, and 17% with an unknown celiac disease status.

    In each case, patients received four biopsy specimens from the second portion of the duodenum. Two were made using the single-biopsy technique of 1 bite per pass of the forceps, and two more using the double-biopsy technique, which takes 2 bites per pass of the forceps.

    Specimens were blindly reviewed to determine orientation, consecutive crypt-to-villous units, and Marsh score. Well-oriented biopsy specimens were noted in 66% of patients with the single-biopsy technique and 42% of patients with the double-biopsy technique (P < .01).

    Analysis of matched pairs showed improved orientation with the single-biopsy technique (odds ratio 3.1; 95% confidence interval, 1.5-7.1; P < .01). This persisted in subgroup analysis of patients with known celiac disease (P = .02), villous atrophy (P = .02), and a final diagnosis of celiac disease (P < .01).

    Now, this is just a single-center trial, so results need to be compared with results from additional cities.

    Interestingly, these results suggest that one bite is actually better than two, because the single-biopsy technique improves the yield of well-oriented duodenal biopsy specimens.

    For best results, the endoscopists should consider taking only one biopsy specimen per pass of the forceps in patients undergoing biopsies of the duodenal mucosa.

    Source:

    0

    User Feedback

    Recommended Comments

    There are no comments to display.



    Join the conversation

    You are posting as a guest. If you have an account, sign in now to post with your account.
    Note: Your post will require moderator approval before it will be visible.

    Guest
    Add a comment...

    ×   Pasted as rich text.   Paste as plain text instead

      Only 75 emoji are allowed.

    ×   Your link has been automatically embedded.   Display as a link instead

    ×   Your previous content has been restored.   Clear editor

    ×   You cannot paste images directly. Upload or insert images from URL.


  • About Me

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,500 articles on celiac disease. His coursework includes studies in science, scientific methodology, biology, anatomy, medicine, logic, and advanced research. He previously served as SF Health News Examiner for Examiner.com, and devised health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.


  • Celiac.com Sponsor (A17):
    Celiac.com Sponsor (A17):





    Celiac.com Sponsors (A17):




  • Related Articles

    Scott Adams
    IgA class Reticulin antibodies are found only in Celiac disease and dermatitis herpetiformis. These antibodies are found in approximately 60% of celiac disease patients and 25% of DH patients. This test is falling into disuse because of the limited utility and the availability of better tests. IgA class endomysial antibodies are very specific, occurring only in celiac disease...

    Dr. Ron Hoggan, Ed.D.
    This article originally appeared in the Autumn 2002 edition of Celiac.coms Scott-Free newsletter.
    Copyright &COPY; 2002 Scott Adams. All rights reserved worldwide.
    Five years ago I became concerned about weakness in my bones after a couple of surprising fractures. At one point, I broke a rib while shingling a storage-shed roof. I leaned across the peak of the roofs...

    Scott Adams
    Celiac.com 11/08/2005 - Today a team of scientists at Alba Therapeutics Corporation (Alba) and the University of Maryland School of Medicine reported a direct link between gluten-induced intestinal permeability and zonulin in tissues from patients with celiac disease. The investigators were able to successfully prevent gluten-induced intestinal tissue leak with the administration...