title: Prevalence of celiac disease in adult patients with refractory functional dyspepsia: value of routine duodenal biopsy.
abstract: OBJECTIVE
  To investigate the prevalence of celiac disease (CD) in adult patients referred to an open access gastroenterology clinic in the south of Italy and submitted to esophago-gastro-duodenoscopy (EGD) for evaluation of refractory functional dyspepsia.
  
  
  METHODS
  Seven hundred and twenty six consecutive dyspeptic patients (282 male, 444 female; mean age 39.6 years, range 18-75 years) with unexplained prolonged dyspepsia were prospectively enrolled. Duodenal biopsies were taken and processed by standard staining. Histological evaluation was carried out according to the Marsh-Oberhuber criteria.
  
  
  RESULTS
  The endoscopic findings were: normal in 61.2%, peptic lesions in 20.5%, malignancies in 0.5%, miscellaneous in 16.7%. CD was endoscopically diagnosed in 8 patients (1.1%), histologically in 15 patients (2%). The endoscopic features alone showed a sensitivity of 34.8% and specificity of 100%, with a positive predictive value (PPV) of 100% and a negative predictive value (NPP) of 97.9%.
  
  
  CONCLUSIONS
  This prospective study showed that CD has a high prevalence (1:48) in adult dyspeptic patients and suggests the routine use of duodenal biopsy in this type of patient undergoing EGD.
authors.affiliation: Department of Surgery, Gastroenterology and Endoscopy Unit, University of Catania, and Cattedra di Gastroenterologia, Azienda Ospedaliero Univeristaria Policlinico Catania, Via Santa Sofia 78, Catania 95125, Italy.
authors.forename: Emiliano
authors.initials: E
authors.lastname: Giangreco
authors.forename: Cinzia
authors.initials: C
authors.lastname: D'agate
authors.forename: Carmelo
authors.initials: C
authors.lastname: Barbera
authors.forename: Lidia
authors.initials: L
authors.lastname: Puzzo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Aprile
authors.forename: Pietro
authors.initials: P
authors.lastname: Naso
authors.forename: Giacomo
authors.initials: G
authors.lastname: Bonanno
authors.forename: Francesco-Paolo
authors.initials: FP
authors.lastname: Russo
authors.forename: Alessandra
authors.initials: A
authors.lastname: Nicoletti
authors.forename: Salvatore
authors.initials: S
authors.lastname: Incarbone
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Trama
authors.forename: Antonio
authors.initials: A
authors.lastname: Russo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy; D002446:Celiac Disease / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology*; D004386:Duodenum / Q000473:pathology; D004415:Dyspepsia / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D016145:Endoscopy, Digestive System; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D012189:Retrospective Studies; D055815:Young Adult