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Naveed Islam¹, Muhammad Zulqarnain Haider Khan², Muhammad Zeeshan Khan³, Hira Saadia¹, Rimsha Khan¹ and Imrana Shaukat¹

ABSTRACT

Objective: To determine the diagnostic accuracy of endoscopic findings of patients with suspected celiac disease taking histological features as gold standard.

Study Design: Descriptive, cross-sectional study

Place and Duration of Study: This study was conducted at the Department of Gastroenterology and Department of Histopathology, Nishtar Medical University, Multan, from January 2022 to December 2022.

Materials and Methods: A total number of 222 patients with suspected diagnosis of celiac disease were included in this study. All patients underwent upper gastrointestinal endoscopy and features were noted. Biopsies was taken from second part of duodenum and submitted for histopathology. All slides were examined by consultant pathologist and findings were noted. Presence of CD on endoscopy and histopathological examination was noted. Two by Two table was generated to compute sensitivity, specificity, PPV and NPV diagnostic accuracy of endoscopic findings taking histopathological features as gold standard. Statistical analysis was done using SPSS version 17.

Results: A total number of two hundred and twenty two (222) suspicious of suffering from celiac disease were included in this study. Mean age of study patients was 41.40+11.90 years. Maximum age was 60 years and minimum age was 20 years. There were more males as compared to females. There were 127 (57.21%) male patients and 95 (42.79%) female patients in this study. Regarding duration of symptoms mean duration of symptoms of study patients was 5.50+4.1 months. Maximum duration of symptoms was 2 years and minimum duration of symptoms was 01 month only. On endoscopic examination, celiac disease was diagnosed in 110 (49.55%) patients while no significant evidence of celiac disease was found in 112 (50.45%) patients. On histologic examination, celiac disease was diagnosed in 133 (59.91%) patients, while 89 (40.09%) were not found of having celiac disease on histologic examination. Regarding accuracy of endoscopy in diagnosing celiac disease taking histopathologic findings as gold standard. The sensitivity of endoscopy was 66.2%, specificity was 75.3%, positive predictive value was 80.0% and negative predictive value was 59.8%.

Conclusion: Endoscopy is a good diagnostic tool for suspected cases of celiac disease as it has high level of sensitivity, specificity, positive predictive value and negative predictive value in our study. Hence endoscopy can be easily employed for early diagnosis of celiac disease which will improve disease outcomes followed by timely management of these cases.

Key Words: Celiac Disease, Endoscopy, Histopathology

Citation of article: Islam N, Khan MZH, Khan MZ, Saadia H, Khan R, Shaukat I. Diagnostic Accuracy of Endoscopic Findings of Patients with Suspected Celiac Disease Taking Histological Features as Gold Standard at Tertiary Care Hospital. Med Forum 2023;34(2):58-61.