Prevalence of celiac disease in adult patients with refractory functional dyspepsia: value of routine duodenal biopsy.
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.
Giangreco
Emiliano
E
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.
D'agate
Cinzia
C
Barbera
Carmelo
C
Puzzo
Lidia
L
Aprile
Giuseppe
G
Naso
Pietro
P
Bonanno
Giacomo
G
Russo
Francesco-Paolo
FP
Nicoletti
Alessandra
A
Incarbone
Salvatore
S
Trama
Giuseppe
G
Russo
Antonio
A
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