Bowel sonography in adult celiac disease: diagnostic accuracy and ultrasonographic features.
BACKGROUND
Celiac disease (CD) is a chronic intolerance to gluten, which induces intestinal mucosal lesions in genetically predisposed individuals. Transabdominal bowel sonography (TABS) is a safe and noninvasive procedure that allows to detect intestinal abnormalities in many conditions, but actually is not routinely part of the diagnostic management of CD.


OBJECTIVE
To evaluate the diagnostic accuracy of TABS in CD patients.


METHODS
Fifty CD patients and 50 dyspeptic subjects (control group) underwent TABS. The presence of fluid-distended small bowel loops with thickened valvulae conniventes and increased peristalsis was considered a TABS sign of CD. All clinical, biochemical, and TABS features were assessed at the diagnosis and revaluated after 1 year of gluten-free diet.


RESULTS
TABS signs were present in 66% of CD patients. Sensitivity, specificity, positive and negative predictive value were 66%, 96%, 94%, and 74%, respectively. TABS findings were recorded in 82% of patients with endoscopical markers of CD, in 87.5% of symptomatic patients, and in 61% of patients without symptoms. After 1 year of gluten-free diet TABS was still abnormal in 20% patients, with no correlation with laboratory tests e/o symptoms.


CONCLUSIONS
Patients with CD frequently present TABS signs of the disease and operators performing sonography every day have to consider the possibility to suggest CD diagnosis and aTTG determination in these subjects.
Castiglione
F
F
Department of Gastroenterology, Facoltà di Medicina e Chirurgia, University Federico II, Via S. Pansini 5, 80131 Naples, Italy. fabcasti@unina.it
Rispo
A
A
Cozzolino
A
A
Camera
L
L
D'Argenio
G
G
Tortora
R
R
Grassia
R
R
Bucci
C
C
Ciacci
C
C
D000293:Adolescent; D000328:Adult; D002446:Celiac Disease / Q000000981:diagnostic imaging* / Q000178:diet therapy; D003937:Diagnosis, Differential; D018753:Diet, Protein-Restricted; D004108:Dilatation, Pathologic / Q000000981:diagnostic imaging; D004415:Dyspepsia / Q000000981:diagnostic imaging; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005500:Follow-Up Studies; D005983:Glutens; D006801:Humans; D007421:Intestine, Small / Q000000981:diagnostic imaging; D007422:Intestines / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D010528:Peristalsis / Q000502:physiology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler
D005983:Glutens