Skip to main content
Erschienen in: Digestive Diseases and Sciences 8/2021

18.08.2020 | Original Article

Crohn’s Disease Only Visible on Small Bowel Capsule Endoscopy: A New Entity

verfasst von: Thomas Chateau, Ferdinando Damico, Camille Zallot, Nicolas Mathieu, Laurent Peyrin-Biroulet

Erschienen in: Digestive Diseases and Sciences | Ausgabe 8/2021

Einloggen, um Zugang zu erhalten

Abstract

Background and Aims

In rare cases, the diagnosis of Crohn’s disease (CD) can only be achieved using small bowel capsule endoscopy (SBCE). We investigate the characteristics of patients with CD only visible on SBCE and assess their disease course.

Methods

Data of all adult patients with confirmed CD diagnosis based on SBCE with normal endoscopic and cross-sectional imaging findings were retrospectively collected in three tertiary-level hospitals from January 2014 to March 2020.

Results

Thirteen patients were included. Ten patients were females, and the mean age at diagnosis was 36 years. Ileum was mostly involved (85%), while duodenum and jejunum were affected in 23% and 38% of the cases, respectively. Nine patients had one segment involved, while four subjects had two or three segments affected. All patients had inflammatory behavior. First treatment consisted of steroids in all cases, and six patients were later treated with immunosuppressant or biologics. After a mean follow-up of 27.5 months, no change in disease behavior, hospitalization, or CD-related surgery was observed.

Conclusions

CD only visible at SBCE is a rare condition with a more favorable disease course compared to general CD with a lower rate of complicated behavior, hospitalization, and surgery, despite a similar use of immunosuppressant or biologics.
Literatur
1.
Zurück zum Zitat Torres J, Mehandru S, Colombel JF, et al. Crohn’s disease. Lancet. 2017;389:1741–1755.CrossRef Torres J, Mehandru S, Colombel JF, et al. Crohn’s disease. Lancet. 2017;389:1741–1755.CrossRef
2.
Zurück zum Zitat Gomollón F, Dignass A, Annese V, et al. 3rd European evidence-based consensus on the diagnosis and management of Crohn’s disease 2016: part 1: diagnosis and medical management. J Crohn Colitis. 2017;11:3–25.CrossRef Gomollón F, Dignass A, Annese V, et al. 3rd European evidence-based consensus on the diagnosis and management of Crohn’s disease 2016: part 1: diagnosis and medical management. J Crohn Colitis. 2017;11:3–25.CrossRef
3.
Zurück zum Zitat Peyrin-Biroulet L, Loftus EV Jr, Colombel JF, Sandborn WJ. The natural history of adult Crohn’s disease in population-based cohorts. Am J Gastroenterol. 2010;105:289–297.CrossRef Peyrin-Biroulet L, Loftus EV Jr, Colombel JF, Sandborn WJ. The natural history of adult Crohn’s disease in population-based cohorts. Am J Gastroenterol. 2010;105:289–297.CrossRef
4.
Zurück zum Zitat Maaser C, Sturm A, Vavricka SR, et al. ECCO-ESGAR guideline for diagnostic assessment in IBD part 1: initial diagnosis, monitoring of known IBD, detection of complications. J Crohns Colitis. 2019;13:144–164.CrossRef Maaser C, Sturm A, Vavricka SR, et al. ECCO-ESGAR guideline for diagnostic assessment in IBD part 1: initial diagnosis, monitoring of known IBD, detection of complications. J Crohns Colitis. 2019;13:144–164.CrossRef
5.
Zurück zum Zitat Manes G, Imbesi V, Ardizzone S, et al. Use of double-balloon enteroscopy in the management of patients with Crohn’s disease: feasibility and diagnostic yield in a high-volume centre for inflammatory bowel disease. Surg Endosc. 2009;23:2790–2795.CrossRef Manes G, Imbesi V, Ardizzone S, et al. Use of double-balloon enteroscopy in the management of patients with Crohn’s disease: feasibility and diagnostic yield in a high-volume centre for inflammatory bowel disease. Surg Endosc. 2009;23:2790–2795.CrossRef
6.
Zurück zum Zitat Iddan G, Meron G, Glukhovsky A, Swain P. Wireless capsule endoscopy. Nature. 2000;405:417.CrossRef Iddan G, Meron G, Glukhovsky A, Swain P. Wireless capsule endoscopy. Nature. 2000;405:417.CrossRef
7.
Zurück zum Zitat Enns RA, Hookey L, Armstrong D, et al. Clinical practice guidelines for the use of video capsule endoscopy. Gastroenterology. 2017;152:497–514.CrossRef Enns RA, Hookey L, Armstrong D, et al. Clinical practice guidelines for the use of video capsule endoscopy. Gastroenterology. 2017;152:497–514.CrossRef
8.
Zurück zum Zitat Hosoe N, Takabayashi K, Ogata H, Kanai T. Capsule endoscopy for small-intestinal disorders: current status. Dig Endosc. 2019;31:498–507.CrossRef Hosoe N, Takabayashi K, Ogata H, Kanai T. Capsule endoscopy for small-intestinal disorders: current status. Dig Endosc. 2019;31:498–507.CrossRef
9.
Zurück zum Zitat Long MD, Barnes E, Isaacs K, et al. Impact of capsule endoscopy on management of inflammatory bowel disease: a single tertiary care center experience. Inflamm Bowel Dis. 2011;17:1855–1862.CrossRef Long MD, Barnes E, Isaacs K, et al. Impact of capsule endoscopy on management of inflammatory bowel disease: a single tertiary care center experience. Inflamm Bowel Dis. 2011;17:1855–1862.CrossRef
10.
Zurück zum Zitat Sorrentino D, Nguyen V. Clinically significant small bowel Crohn’s disease might only be detected by capsule endoscopy. Inflamm Bowel Dis. 2018;24:1566–1574.CrossRef Sorrentino D, Nguyen V. Clinically significant small bowel Crohn’s disease might only be detected by capsule endoscopy. Inflamm Bowel Dis. 2018;24:1566–1574.CrossRef
11.
Zurück zum Zitat Dionisio PM, Gurudu SR, Leighton JA, et al. Capsule endoscopy has a significantly higher diagnostic yield in patients with suspected and established small bowel Crohn’s disease: a meta-analysis. Am J Gastroenterol. 2010;105:1240–1248.CrossRef Dionisio PM, Gurudu SR, Leighton JA, et al. Capsule endoscopy has a significantly higher diagnostic yield in patients with suspected and established small bowel Crohn’s disease: a meta-analysis. Am J Gastroenterol. 2010;105:1240–1248.CrossRef
12.
Zurück zum Zitat González-Suárez B, Rodriguez S, Ricart E, et al. Comparison of capsule endoscopy and magnetic resonance enterography for the assessment of small bowel lesions in Crohn’s disease. Inflamm Bowel Dis. 2018;24:775–780.CrossRef González-Suárez B, Rodriguez S, Ricart E, et al. Comparison of capsule endoscopy and magnetic resonance enterography for the assessment of small bowel lesions in Crohn’s disease. Inflamm Bowel Dis. 2018;24:775–780.CrossRef
13.
Zurück zum Zitat Beaugerie L, Seksik P, Nion-Larmurier I, et al. Predictors of Crohn’s disease. Gastroenterology. 2006;130:650–656.CrossRef Beaugerie L, Seksik P, Nion-Larmurier I, et al. Predictors of Crohn’s disease. Gastroenterology. 2006;130:650–656.CrossRef
14.
Zurück zum Zitat Cosnes J, Bourrier A, Nion-Larmurier I, Sokol H, Beaugerie L, Seksik P. Factors affecting outcomes in Crohn’s disease over 15 years. Gut. 2012;61:1140–1145.CrossRef Cosnes J, Bourrier A, Nion-Larmurier I, Sokol H, Beaugerie L, Seksik P. Factors affecting outcomes in Crohn’s disease over 15 years. Gut. 2012;61:1140–1145.CrossRef
15.
Zurück zum Zitat Eglinton TW, Barclay ML, Gearry RB, Frizelle FA. The spectrum of perianal Crohn’s disease in a population-based cohort. Dis Colon Rectum. 2012;55:773–777.CrossRef Eglinton TW, Barclay ML, Gearry RB, Frizelle FA. The spectrum of perianal Crohn’s disease in a population-based cohort. Dis Colon Rectum. 2012;55:773–777.CrossRef
16.
Zurück zum Zitat Panes J, Bouzas R, Chaparro M, et al. Systematic review: the use of ultrasonography, computed tomography and magnetic resonance imaging for the diagnosis, assessment of activity and abdominal complications of Crohn’s disease. Aliment Pharmacol Ther. 2011;34:125–145.CrossRef Panes J, Bouzas R, Chaparro M, et al. Systematic review: the use of ultrasonography, computed tomography and magnetic resonance imaging for the diagnosis, assessment of activity and abdominal complications of Crohn’s disease. Aliment Pharmacol Ther. 2011;34:125–145.CrossRef
17.
Zurück zum Zitat Thia KT, Sandborn WJ, Harmsen WS, et al. Risk factors associated with progression to intestinal complications of Crohn’s disease in a population-based cohort. Gastroenterology. 2010;139:1147–1155.CrossRef Thia KT, Sandborn WJ, Harmsen WS, et al. Risk factors associated with progression to intestinal complications of Crohn’s disease in a population-based cohort. Gastroenterology. 2010;139:1147–1155.CrossRef
18.
Zurück zum Zitat Guizzetti L, Zou G, Khanna R, et al. Development of clinical prediction models for surgery and complications in Crohn’s disease. J Crohns Colitis. 2018;12:167–177.CrossRef Guizzetti L, Zou G, Khanna R, et al. Development of clinical prediction models for surgery and complications in Crohn’s disease. J Crohns Colitis. 2018;12:167–177.CrossRef
19.
Zurück zum Zitat Chow DK, Sung JJ, Wu JC, et al. Upper gastrointestinal tract phenotype of Crohn’s disease is associated with early surgery and further hospitalization. Inflamm Bowel Dis. 2009;15:551–557.CrossRef Chow DK, Sung JJ, Wu JC, et al. Upper gastrointestinal tract phenotype of Crohn’s disease is associated with early surgery and further hospitalization. Inflamm Bowel Dis. 2009;15:551–557.CrossRef
20.
Zurück zum Zitat Lazarev M, Huang C, Bitton A, et al. Relationship between proximal Crohn’s disease location and disease behavior and surgery: a cross-sectional study of the IBD Genetics Consortium. Am J Gastroenterol. 2013;108:106–112.CrossRef Lazarev M, Huang C, Bitton A, et al. Relationship between proximal Crohn’s disease location and disease behavior and surgery: a cross-sectional study of the IBD Genetics Consortium. Am J Gastroenterol. 2013;108:106–112.CrossRef
21.
Zurück zum Zitat Cosnes J, Cattan S, Blain A, et al. Long-term evolution of disease behavior of Crohn’s disease. Inflamm Bowel Dis. 2002;8:244–250.CrossRef Cosnes J, Cattan S, Blain A, et al. Long-term evolution of disease behavior of Crohn’s disease. Inflamm Bowel Dis. 2002;8:244–250.CrossRef
22.
Zurück zum Zitat Girelli CM, Porta P, Malacrida V, Barzaghi F, Rocca F. Clinical outcome of patients examined by capsule endoscopy for suspected small bowel Crohn’s disease. Dig Liver Dis. 2007;39:148–154.CrossRef Girelli CM, Porta P, Malacrida V, Barzaghi F, Rocca F. Clinical outcome of patients examined by capsule endoscopy for suspected small bowel Crohn’s disease. Dig Liver Dis. 2007;39:148–154.CrossRef
23.
Zurück zum Zitat Egea-Valenzuela J, Carrilero-Zaragoza G, Iglesias-Jorquera E, et al. Historical analysis of experience with small bowel capsule endoscopy in a Spanish tertiary hospital. Gastroenterol Hepatol. 2017;40:70–79.CrossRef Egea-Valenzuela J, Carrilero-Zaragoza G, Iglesias-Jorquera E, et al. Historical analysis of experience with small bowel capsule endoscopy in a Spanish tertiary hospital. Gastroenterol Hepatol. 2017;40:70–79.CrossRef
24.
Zurück zum Zitat Katsinelos P, Fasoulas K, Beltsis A, et al. Diagnostic yield and clinical impact of wireless capsule endoscopy in patients with chronic abdominal pain with or without diarrhea: a Greek multicenter study. Eur J Intern Med. 2011;22:63–66.CrossRef Katsinelos P, Fasoulas K, Beltsis A, et al. Diagnostic yield and clinical impact of wireless capsule endoscopy in patients with chronic abdominal pain with or without diarrhea: a Greek multicenter study. Eur J Intern Med. 2011;22:63–66.CrossRef
25.
Zurück zum Zitat Carretero C, Prieto-Frías C, Muñoz-Navas M. Capsule reading is resources consuming. How can we make the best of it. Rev Esp Enferm Dig. 2015;107:331–333.PubMed Carretero C, Prieto-Frías C, Muñoz-Navas M. Capsule reading is resources consuming. How can we make the best of it. Rev Esp Enferm Dig. 2015;107:331–333.PubMed
26.
Zurück zum Zitat Egea-Valenzuela J, Suárez B, Bernald C, et al. Development and validation of a scoring index to predict the presence of lesions in capsule endoscopy in patients with suspected Crohn’s disease of the small bowel: a Spanish multicenter study. Eur J Gastroenterol Hepatol. 2018;30:499–505.CrossRef Egea-Valenzuela J, Suárez B, Bernald C, et al. Development and validation of a scoring index to predict the presence of lesions in capsule endoscopy in patients with suspected Crohn’s disease of the small bowel: a Spanish multicenter study. Eur J Gastroenterol Hepatol. 2018;30:499–505.CrossRef
28.
Zurück zum Zitat Ponte A, Pinho R, Rodrigues A, et al. Evaluation and comparison of capsule endoscopy scores for assessment of inflammatory activity of small-bowel in Crohn’s disease. Gastroenterol Hepatol. 2018;41:245–250.CrossRef Ponte A, Pinho R, Rodrigues A, et al. Evaluation and comparison of capsule endoscopy scores for assessment of inflammatory activity of small-bowel in Crohn’s disease. Gastroenterol Hepatol. 2018;41:245–250.CrossRef
29.
Zurück zum Zitat Yablecovitch D, Lahat A, Neuman S, et al. The Lewis score or the capsule endoscopy Crohn’s disease activity index: which one is better for the assessment of small bowel inflammation in established Crohn’s disease? Ther Adv Gastroenterol. 2018;14:11. Yablecovitch D, Lahat A, Neuman S, et al. The Lewis score or the capsule endoscopy Crohn’s disease activity index: which one is better for the assessment of small bowel inflammation in established Crohn’s disease? Ther Adv Gastroenterol. 2018;14:11.
Metadaten
Titel
Crohn’s Disease Only Visible on Small Bowel Capsule Endoscopy: A New Entity
verfasst von
Thomas Chateau
Ferdinando Damico
Camille Zallot
Nicolas Mathieu
Laurent Peyrin-Biroulet
Publikationsdatum
18.08.2020
Verlag
Springer US
Erschienen in
Digestive Diseases and Sciences / Ausgabe 8/2021
Print ISSN: 0163-2116
Elektronische ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-020-06553-3

Weitere Artikel der Ausgabe 8/2021

Digestive Diseases and Sciences 8/2021 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Mehr Lebenszeit mit Abemaciclib bei fortgeschrittenem Brustkrebs?

24.05.2024 Mammakarzinom Nachrichten

In der MONARCHE-3-Studie lebten Frauen mit fortgeschrittenem Hormonrezeptor-positivem, HER2-negativem Brustkrebs länger, wenn sie zusätzlich zu einem nicht steroidalen Aromatasehemmer mit Abemaciclib behandelt wurden; allerdings verfehlte der numerische Zugewinn die statistische Signifikanz.

ADT zur Radiatio nach Prostatektomie: Wenn, dann wohl länger

24.05.2024 Prostatakarzinom Nachrichten

Welchen Nutzen es trägt, wenn die Strahlentherapie nach radikaler Prostatektomie um eine Androgendeprivation ergänzt wird, hat die RADICALS-HD-Studie untersucht. Nun liegen die Ergebnisse vor. Sie sprechen für länger dauernden Hormonentzug.

„Überwältigende“ Evidenz für Tripeltherapie beim metastasierten Prostata-Ca.

22.05.2024 Prostatakarzinom Nachrichten

Patienten mit metastasiertem hormonsensitivem Prostatakarzinom sollten nicht mehr mit einer alleinigen Androgendeprivationstherapie (ADT) behandelt werden, mahnt ein US-Team nach Sichtung der aktuellen Datenlage. Mit einer Tripeltherapie haben die Betroffenen offenbar die besten Überlebenschancen.

So sicher sind Tattoos: Neue Daten zur Risikobewertung

22.05.2024 Melanom Nachrichten

Das größte medizinische Problem bei Tattoos bleiben allergische Reaktionen. Melanome werden dadurch offensichtlich nicht gefördert, die Farbpigmente könnten aber andere Tumoren begünstigen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.