آيا انجام بيوپسي معمول از دوازدهه در آندوسكوپي فوقاني دستگاه گوارش به منظور غربالگري بيماري سلياك براي همه بيماران ضروري است؟

Is It OK or Not? To Do Routine Duodenal Biopsies for Every Patient Undergoing Upper GI Endoscopy

Background: Coeliac disease (CD) is characterized by malabsorption resulting from inflammatory injury to the mucosa of the small intestine by an inappropriate immune response to dietary gluten proteins. The aim of this study was to assess the prevalence of CD in our endoscopy unit by taking routine duodenal biopsies during upper GI endoscopy. Materials and Methods: Nine hundred and thirteen patients referred to our clinic during a period of 18 months. Patients were divided into three subgroups according to their indications for endoscopy. Group I involved 142 patients with classical symptoms. Group II included 50 patients with the so-called associated disorders of CD and Group III was composed of 573 patients with atypical gastrointestinal symptoms. In all patients upper GI endoscopy was performed and biopsy specimens were taken from second part of duodenum. Results: Seven hundred and sixty five patients were available for follow up. Nine patients were found to have CD (5 men, 4 women).The prevalence of CD in group I, II and III were 9/142 (6.3 %), 0/50 (0%), and 0/573 (0%) respectively. Significant differences in the prevalence of CD among these three subgroups were recognized (P<0.05). Conclusion: Patients should be selected for duodenal biopsies considering their clinical presentations, endoscopic findings, taking biopsies from all patients without any indications does not seem to be appropriate.