Is duodenal biopsy appropriate in areas endemic for ?

OBJECTIVE

The primary reason for obtaining duodenal biopsy sample is to diagnose celiac disease. () and drug injury are common causes of duodenitis. The aim of this retrospective study was to explore effects of and drugs on duodenal mucosa.

METHODS

Duodenal biopsy samples of patients who underwent upper gastrointestinal endoscopy (UGIE) between February 2014 and December 2014 were retrospectively examined. Clinical symptoms, referral indications, endoscopic findings, status, and drug history were recorded. Duodenal biopsy findings were compared based on presence of and drug history.

RESULTS

Of 2389 patients who underwent UGIE, 206 had duodenal biopsy. Eight patients (3.9%) were diagnosed with celiac disease. After excluding cases with celiac disease, 76 patients of remaining 198 patients (36.9%) had duodenal histopathological abnormality. was found in 95 (47.9%) patients. Drug usage was less common (42%). Of patients who had histopathological duodenitis, 59% were -infected. Rate of duodenitis was higher in (+) group than in (-) group (45% vs 27.1%; odds ratio, 2.4; 95% confidence interval, 1.3-4.4; p=0.005). There was no difference between groups regarding drug use in terms of histopathological duodenitis.

CONCLUSION

is the major contributor to duodenitis in high prevalence regions. Serological testing may be more appropriate before performing duodenal biopsy in patients with suspected celiac disease.