The diagnostic value of capsule endoscopy in children with intestinal lymphangiectasia
- 1 January 2021
- journal article
- research article
- Published by Sociedad Espanola de Patologia Digestiva (SEPD) in Revista Española de Enfermedades Digestivas
- Vol. 113 (11), 765-769
- https://doi.org/10.17235/reed.2021.7682/2020
Abstract
Background: intestinal lymphangiectasia is an unusual cause of protein-losing enteropathy due to either congenital malformation or obstruction of the intestinal lymphatics. However, few reports have investigated the use of video capsule endoscopy in children with intestinal lymphangiectasia. This study was performed to evaluate the diagnostic value of video capsule endoscopy for pediatric intestinal lymphangiectasia. Methods: in this retrospective study, all patients who underwent video capsule endoscopy between January 2014 and July 2020 were included. Clinical information and video capsule endoscopy data were analyzed. Results: twelve children were enrolled, 7 males and 5 females, with an age at disease onset of 4.5 (range: 3.2-9.3) years and a disease duration of 12.0 (range: 1.3-30.0) months. The most common symptoms were hypoproteinemia (10, 83.3 %), diarrhea (7, 58.3 %), edema (6, 50.0 %), and abdominal pain (3, 25.0 %). Eight patients had low lymphocyte counts, whereas 10 had reduced serum albumin levels (23.2 +/- 5.8 g/L). Video capsule endoscopy revealed an overall white snowy appearance due to the presence of whitish, swollen villi in all patients. Regarding the macroscopic lesions of lymphangiectasia, 7 cases involved the entire small bowel from the duodenum to the ileocecal valve, while 5 cases involved part of the small bowel. All patients were treated with medium-chain triglyceride diets, and albumin infusions were administered to 10 patients; sirolimus treatment was administered to 3 patients. At the last follow-up, 5 patients still had hypoalbuminemia and one patient had died of intestinal lymphoma. Conclusion: video capsule endoscopy is useful for the diagnosis of intestinal lymphangiectasia and should be applied as a valuable and less invasive examination to confirm or establish a diagnosis.Keywords
This publication has 18 references indexed in Scilit:
- Classification of Intestinal Lymphangiectasia with Protein-Losing Enteropathy: White Villi Type and Non-White Villi TypeDigestion, 2014
- Diffuse Large B-Cell Lymphoma Recurrence Complicating Primary Intestinal LymphangiectasiaClinical Gastroenterology and Hepatology, 2013
- Evaluation of primary intestinal lymphangiectasia by capsule endoscopyEndoscopy, 2013
- Primary intestinal lymphangiectasia diagnosed by capsule endoscopy and double balloon enteroscopyWorld Journal of Gastrointestinal Endoscopy, 2011
- Primary intestinal lymphangiectasia (Waldmann's disease)Orphanet Journal of Rare Diseases, 2008
- Clinical Application and Diagnostic Yield of Wireless Capsule Endoscopy in ChildrenJournal of Laparoendoscopic & Advanced Surgical Techniques, 2007
- Use of capsule endoscopy in children with primary intestinal lymphangiectasiaGastrointestinal Endoscopy, 2006
- Videocapsule endoscopy is useful for the diagnosis of intestinal lymphangiectasiaDigestive and Liver Disease, 2006
- The development and application of wireless capsule endoscopyInternational Journal of Medical Robotics and Computer Assisted Surgery, 2004
- The development and application of wireless capsule endoscopyInternational Journal of Medical Robotics and Computer Assisted Surgery, 2004