Valle Julio, Alcántara Mariano, Pérez-Grueso María José, Navajas Javier, Muñoz-Rosas Concepción, Legaz Maria Luisa, Cuena Rafael, Carrobles José María
Department of Gastroenterology, Hospital Virgen de la Salud, Toledo, Spain.
J Clin Gastroenterol. 2006 Sep;40(8):692-6. doi: 10.1097/00004836-200609000-00006.
Capsule endoscopy (CE) can detect Crohn's disease in patients with suggestive symptoms but with negative results from the traditional diagnostic work-up (ileocolonoscopy and small bowel follow-through). The objective of this study was to determine which clinical features predict the diagnosis of Crohn's disease by CE in this subgroup of patients.
Twenty-three patients (7 men, 16 women; mean age: 40+/-15 y) with negative results from conventional imaging techniques were prospectively included in the study because of suspicion of Crohn's disease (long-standing abdominal pain and/or diarrhea and at least one of the following symptoms: anemia, weight loss, long-standing fever, perianal disease, extraintestinal manifestations typical of inflammatory bowel disease, elevated inflammatory parameters, or family history of inflammatory bowel disease).
CE diagnosed Crohn's disease in 6 patients (26%). Crohn's disease diagnosis was more frequent in patients with a combination of anemia and elevated inflammatory parameters than in patients without this combination (57% vs. 12.5%; P=0.04). The only statistically significant association between an inflammatory parameter and Crohn's disease was an increased platelet count.
CE is a useful tool for the diagnosis of subtle small bowel Crohn's disease. The diagnostic yield of CE in patients with suspicion of Crohn's disease but negative results from the traditional diagnostic work-up is significantly higher in patients with anemia and increased platelet count than in patients without this combination of clinical features.
胶囊内镜（CE）可在有提示性症状但传统诊断检查（回结肠镜检查和小肠钡剂造影）结果为阴性的患者中检测出克罗恩病。本研究的目的是确定哪些临床特征可预测该亚组患者通过CE诊断克罗恩病。
23例（7例男性，16例女性；平均年龄：40±15岁）传统成像技术结果为阴性的患者因怀疑患有克罗恩病（长期腹痛和/或腹泻以及以下至少一种症状：贫血、体重减轻、长期发热、肛周疾病、炎症性肠病典型的肠外表现、炎症指标升高或炎症性肠病家族史）而被前瞻性纳入研究。
CE诊断出6例（26%）克罗恩病患者。与无贫血和炎症指标升高组合的患者相比，有贫血和炎症指标升高组合的患者中克罗恩病诊断更为常见（57%对12.5%；P = 0.04）。炎症指标与克罗恩病之间唯一具有统计学意义的关联是血小板计数增加。
CE是诊断隐匿性小肠克罗恩病的有用工具。对于怀疑患有克罗恩病但传统诊断检查结果为阴性的患者，有贫血和血小板计数增加的患者中CE的诊断率显著高于无此临床特征组合的患者。
