Academic Department of Gastroenterology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals, Sheffield,
Academic Department of Gastroenterology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals, Sheffield, UK.
J Gastrointestin Liver Dis. 2019 Mar;28(1):15-22. doi: 10.15403/jgld.2014.1121.281.cel.
There is no literature on the role of repeat small bowel capsule endoscopy (SBCE) in patients with refractory coeliac disease (RCD) following treatment with steroids +/- immunosuppressants.
The findings on SBCEs from a group of patients with histologically proven RCD (n=23) were compared to the findings from patients with uncomplicated coeliac disease (n=48). All patients had concurrent duodenal histology and serology taken at the time of SBCE.
Patients with RCD had a greater extent of mucosal involvement on SBCE than patients with uncomplicated CD (42.4+/-34.1% vs 9.7+/-21.7%, p=0.0001). Following treatment with steroids and / or immunosuppressants, patients with RCD had an improvement in the extent of affected small bowel mucosa (42.4+/-34.1% vs 26.4+/-28.9% p=0.012). There was no statistical difference in histology and serology taken at the time of the first and second SBCE in patients with RCD.
Our study suggests that SBCE is valuable in documenting the extent of mucosal involvement in patients with RCD. This is the first study that delineates the value of a second look SBCE to assess improvement in the extent of disease in the small bowel following treatment.
在接受类固醇 +/- 免疫抑制剂治疗后的难治性乳糜泻（RCD）患者中，重复小肠胶囊内镜（SBCE）的作用尚无文献报道。
将一组经组织学证实的 RCD 患者（n=23）的 SBCE 检查结果与单纯乳糜泻患者（n=48）的检查结果进行比较。所有患者在进行 SBCE 检查时均同时进行了十二指肠组织学和血清学检查。
与单纯 CD 患者相比，RCD 患者的 SBCE 黏膜受累程度更大（42.4+/-34.1% vs 9.7+/-21.7%，p=0.0001）。在接受类固醇和/或免疫抑制剂治疗后，RCD 患者的受累小肠黏膜程度有所改善（42.4+/-34.1% vs 26.4+/-28.9%，p=0.012）。在 RCD 患者中，第一次和第二次 SBCE 时的组织学和血清学检查没有统计学差异。
我们的研究表明，SBCE 可用于记录 RCD 患者黏膜受累的程度。这是首次研究表明，第二次 SBCE 可评估治疗后小肠疾病程度的改善。
