title: Duodenal endoscopic findings and histopathologic confirmation of intestinal lymphangiectasia in dogs.
abstract: BACKGROUND
  The diagnosis of intestinal lymphangiectasia (IL) has been associated with characteristic duodenal mucosal changes. However, the sensitivity and specificity of the endoscopic duodenal mucosal appearance for the diagnosis of IL are not reported.
  
  
  OBJECTIVE
  To evaluate the utility of endoscopic images of the duodenum for diagnosis of IL. Endoscopic appearance of the duodenal mucosal might predict histopathologic diagnosis of IL with a high degree of sensitivity and specificity.
  
  
  METHODS
  51 dogs that underwent upper gastrointestinal (GI) endoscopy and endoscopic biopsies.
  
  
  METHODS
  Retrospective review of images acquired during endoscopy. Dogs were included if adequate biopsies were obtained during upper GI endoscopy and digital images were saved during the procedure. Images were assessed for the presence and severity of IL. Using histopathology as the gold standard, the sensitivity and specificity of endoscopy for diagnosing IL were calculated.
  
  
  RESULTS
  Intestinal lymphangiectasia (IL) was diagnosed in 25/51 dogs. Gross endoscopic appearance of the duodenal mucosa had a sensitivity and specificity (95% confidence interval) of 68% (46%, 84%) and 42% (24%, 63%), respectively for diagnosis of IL. Endoscopic images in cases with lymphopenia, hypocholesterolemia, and hypoalbuminemia had a sensitivity of 80%.
  
  
  CONCLUSIONS
  Endoscopic duodenal mucosa appearance alone lacks specificity and has only a moderate sensitivity for diagnosis of IL. Evaluation of biomarkers associated with PLE improved the sensitivity; however, poor specificity for diagnosis of IL supports the need for histopathologic confirmation.
authors: Department of Medical Sciences, University of Wisconsin-Madison, School of Veterinary Medicine, Madison, WI 53706, USA.
authors: R N
authors: RN
authors: Larson
authors: J A
authors: JA
authors: Ginn
authors: C M
authors: CM
authors: Bell
authors: M J
authors: MJ
authors: Davis
authors: D S
authors: DS
authors: Foy
mesh_terms: D000818:Animals; D001706:Biopsy / Q000662:veterinary; D004283:Dog Diseases / Q000175:diagnosis / Q000473:pathology*; D004285:Dogs; D004378:Duodenal Diseases / Q000175:diagnosis / Q000473:pathology / Q000662:veterinary*; D016145:Endoscopy, Digestive System / Q000379:methods / Q000592:standards / Q000662:veterinary*; D005260:Female; D008201:Lymphangiectasis, Intestinal / Q000175:diagnosis / Q000473:pathology / Q000662:veterinary*; D008297:Male; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric