Random duodenal biopsy to exclude coeliac disease as a cause of anaemia is not cost-efective and should be replaced with universally performed pre-endoscopy serology in patients on a suspected cancer pathway

Techniques in Coloproctology
P J J Herrod, J N Lund

Abstract

Random duodenal biopsy to exclude coeliac disease during upper gastrointestinal endoscopy for the investigation of iron deficiency anaemia remains a common procedure, but is expensive and time-consuming. Serological investigation for coeliac disease is also recommended, having excellent accuracy with the added benefit of lower cost. This study sought to examine the utility of duodenal biopsy and coeliac serology in the diagnosis of coeliac disease. A prospectively maintained database was interrogated to identify all patients having upper gastrointestinal endoscopy for the investigation of anaemia between January 01, 2016, and December 31, 2016. Of the 1131 patients having an endoscopy, coeliac serology was measured in only 412 (36%) and was positive in 9 cases (2%), leading to 6 histological diagnoses of coeliac disease and 3 false positives. Two-hundred and seventy-four patients with negative serology had biopsies taken which were all negative. Only 2/451 (0.4%) patients who had biopsies performed in the absence of a serology test were histologically positive for coeliac disease. The cost per diagnosis of a case of coeliac disease in those with either negative or absent coeliac serology was £18,839 (US$25,244, €21,196). Random...Continue Reading

References

Jan 1, 1993·Gut·B Scott, G Holmes
Apr 29, 1998·Canadian Journal of Gastroenterology = Journal Canadien De Gastroenterologie·H J Freeman
May 1, 1954·The American Journal of Digestive Diseases·R S NELSON
Jan 25, 2006·Canadian Journal of Gastroenterology = Journal Canadien De Gastroenterologie·D R Diniz-SantosLuciana R Silva
Apr 25, 2006·Dysphagia·Richard S BloomfeldBenoit C Pineau
Sep 4, 2007·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·A G ShawJ N Lund
Jan 16, 2008·Alimentary Pharmacology & Therapeutics·P G Hill, G K T Holmes
Mar 21, 2008·Canadian Journal of Gastroenterology = Journal Canadien De Gastroenterologie·H J Freeman
Apr 24, 2013·The American Journal of Gastroenterology·Alberto Rubio-TapiaUNKNOWN American College of Gastroenterology
Apr 27, 2013·Annals of Oncology : Official Journal of the European Society for Medical Oncology·K GarborgM Bretthauer
May 10, 2013·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·O PeacockJ N Lund
Jun 12, 2014·Gut·Jonas F LudvigssonUNKNOWN British Society of Gastroenterology
Mar 31, 2015·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Janie J YangBenjamin Lebwohl
Apr 26, 2017·European Journal of Gastroenterology & Hepatology·Geoffrey K T HolmesAndrew S Austin

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Citations

Sep 18, 2018·PharmacoEconomics·Elizabeth S MearnsBenjamin Lebwohl
Jul 18, 2019·Medicina·Daniel Vasile BalabanMariana Jinga

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BETA
biopsy
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Excel

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