Gastroenterology
Volume 135, Issue 6 , Pages 1870-1876 , December 2008

In Vivo Confocal Endomicroscopy in the Diagnosis and Evaluation of Celiac Disease

  • Rupert W.L. Leong

      Affiliations

    • Gastroenterology and Liver Services, Sydney South West Area Health Service, Bankstown-Lidcombe Hospital, Sydney, Australia
    • Gastroenterology and Liver Services, Sydney South West Area Health Service, Concord Hospital, Sydney, Australia
    • Faculty of Medicine, The University of New South Wales, Sydney, Australia
    • Garvan Institute of Medical Research, Sydney, Australia
    • Corresponding Author InformationAddress requests for reprints to: Associate Professor Rupert W. L. Leong, MBBS, FRACP, MD, Department of Gastroenterology and Hepatology, Level 3, Bankstown-Lidcombe Hospital, Eldridge Road, Bankstown, New South Wales 2200, Australia. fax: (61) (2) 9722-7752
    • ,
  • Nam Q. Nguyen

      Affiliations

    • Gastroenterology and Liver Services, Sydney South West Area Health Service, Bankstown-Lidcombe Hospital, Sydney, Australia
    • Garvan Institute of Medical Research, Sydney, Australia
    • ,
  • Christopher G. Meredith

      Affiliations

    • Gastroenterology and Liver Services, Sydney South West Area Health Service, Bankstown-Lidcombe Hospital, Sydney, Australia
    • ,
  • Sam Al–Sohaily

      Affiliations

    • Gastroenterology and Liver Services, Sydney South West Area Health Service, Bankstown-Lidcombe Hospital, Sydney, Australia
    • Gastroenterology and Liver Services, Sydney South West Area Health Service, Concord Hospital, Sydney, Australia
    • Garvan Institute of Medical Research, Sydney, Australia
    • ,
  • Darko Kukic

      Affiliations

    • Gastroenterology and Liver Services, Sydney South West Area Health Service, Bankstown-Lidcombe Hospital, Sydney, Australia
    • ,
  • Peter M. Delaney

      Affiliations

    • Optiscan Pty Ltd, Melbourne, Australia
    • ,
  • Elise R. Murr

      Affiliations

    • Optiscan Pty Ltd, Melbourne, Australia
    • ,
  • Jim Yong

      Affiliations

    • South West Area Pathology Service, Sydney South West Area Health Service, Sydney, Australia
    • ,
  • Neil D. Merrett

      Affiliations

    • Gastroenterology and Liver Services, Sydney South West Area Health Service, Bankstown-Lidcombe Hospital, Sydney, Australia
    • Faculty of Medicine, The University of New South Wales, Sydney, Australia
    • Garvan Institute of Medical Research, Sydney, Australia
    • ,
  • Andrew V. Biankin

      Affiliations

    • Gastroenterology and Liver Services, Sydney South West Area Health Service, Bankstown-Lidcombe Hospital, Sydney, Australia
    • Faculty of Medicine, The University of New South Wales, Sydney, Australia
    • Garvan Institute of Medical Research, Sydney, Australia

Received 23 April 2008 ,Accepted 14 August 2008.

References 

  1. Leffler DA, Kelly CP. Update on the evaluation and diagnosis of celiac disease. Curr Opin Allergy Clin Immunol. 2006;6:191–196
  2. National Institutes of Health. Consensus Development Conference Statement on Celiac Disease, June 28–30, 2004. Gastroenterology. 2005;128(Suppl 1):S1–S9
  3. Dewar DH, Ciclitira PJ. Clinical features and diagnosis of celiac disease. Gastroenterology. 2005;128(Suppl 1):S19–S24
  4. Bardella MT, Minoli G, Radaelli F, et al. Re-evaluation of duodenal endoscopic markers in the diagnosis of celiac disease. Gastrointest Endosc. 2000;51:714–716
  5. Lecleire S, Di Fiore F, Antonietti M, et al. Endoscopic markers of villous atrophy are not useful for the detection of celiac disease in patients with dyspeptic symptoms. Endoscopy. 2006;38:696–701
  6. Ravelli A, Bolognini S, Gambarotti M, et al. Variability of histologic lesions in relation to biopsy site in gluten-sensitive enteropathy. Am J Gastroenterol. 2005;100:177–185
  7. Shidrawl RG, Przemiosolo R, Davis DR, et al. Pitfalls in diagnosing coeliac disease. J Clin Pathol. 1994;47:693–694
  8. Thijs WJ, van Baarlen J, Kleibeuker JH, et al. Duodenal versus jejunal biopsies in suspected celiac disease. Endoscopy. 2004;36:993–996
  9. Shiffman ML, Farrel MT, Yee YS. Risk of bleeding after endoscopic biopsy or polypectomy in patients taking aspirin or other NSAIDS. Gastrointest Endosc. 1994;40:458–462
  10. Damore LT, Rantis PC, Vernava AM, et al. Colonoscopic perforations (Etiology, diagnosis, and management). Dis Colon Rectum. 1996;39:1308–1314
  11. Polglase AL, McLaren WJ, Skinner SA, et al. A fluorescence confocal endomicroscope for in vivo microscopy of the upper- and the lower-GI tract. Gastrointest Endosc. 2005;62:686–695
  12. Wainwright M. Dyes in the development of drugs and pharmaceuticals. Dyes Pigments. 2008;76:582–589
  13. Oberhuber G, Granditsch G, Vogelsang H. The histopathology of coeliac disease: time for a standardized report scheme for pathologists. Eur J Gastroenterol Hepatol. 1999;11:1185–1194
  14. Kakar S, Nehra V, Murray JA, et al. Significance of intraepithelial lymphocytosis in small bowel biopsy samples with normal mucosal architecture. Am J Gastroenterol. 2003;98:2027–2033
  15. Lahdeaho ML, Kaukinen K, Collin P, et al. Celiac disease: from inflammation to atrophy: a long-term follow-up study. J Paediatr Gastroenterol Nutr. 2005;41:44–48
  16. Zambelli A, Villanacci V, Buscarini E, et al. Confocal laser endomicroscopy in celiac disease: description of findings in two cases. Endoscopy. 2007;39:1018–1020
  17. Trovato C, Sonzogni A, Ravizza D, et al. Celiac disease: in vivo diagnosis by confocal endomicroscopy. Gastrointest Endosc. 2007;65:1096–1099
  18. Kiesslich R, Burg J, Vieth M, et al. Confocal laser endoscopy for diagnosing intraepithelial neoplasia and colorectal cancer in vivo. Gastroenterology. 2004;127:706–713
  19. Kiesslich R, Goetz M, Burg J, Stolte , et al. Diagnosing Helicobacter pylori in vivo by confocal laser endoscopy. Gastroenterology. 2005;128:2119–2123
  20. Kitabatake S, Niwa Y, Miyahara R, et al. Confocal endomicroscopy for the diagnosis of gastric cancer in vivo. Endoscopy. 2006;38:1110–1114
  21. Kiesslich R, Gossner L, Goetz M, et al. In vivo histology of Barrett's esophagus and associated neoplasia by confocal laser endomicroscopy. Clin Gastroenterol Hepatol. 2006;4:979–987
  22. Kiesslich R, Hoffman A, Goetz M, et al. In vivo diagnosis of collagenous colitis by confocal endomicroscopy. Gut. 2006;55:591–592
  23. Hurlstone DP, Kiesslich R, Thomson M, et al. Confocal chromoscopic endomicroscopy is superior to chromoscopy alone for the detection and characterisation of intraepithelial neoplasia in chronic ulcerative colitis. Gut. 2008;57:196–204
  24. Nguyen NQ, Leong RW. Current application of confocal endomicroscopy in gastrointestinal disorders. J Gastroenterol Hepatol. 2008;23:1483–1491

 The authors disclose the following: this study was partially funded by an Early Career Researcher Faculty Research Grant from The University of New South Wales. The research was investigator-initiated. The authors have no financial conflicts of interest to report with the exception of Elise Murr and Peter Delaney, who are paid employees of Optiscan Pty Ltd, Australia. Optiscan Pty Ltd (E.M., P.D.) supported the instrument for research purposes. Optiscan Pty Ltd were not involved in the running of the study and did not influence the results of the study in any way.

PII: S0016-5085(08)01611-9

doi: 10.1053/j.gastro.2008.08.054

Gastroenterology
Volume 135, Issue 6 , Pages 1870-1876 , December 2008

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