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Published on: October 16, 2013

Scalloping is a reliable endoscopic marker for celiac disease

Yair Kasirer1, Dan Turner, Leora Lerman

  • 1The Pediatric Gastroenterology and Nutrition Unit, Shaare Zedek Medical Center, Jerusalem, Israel.

Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society
|June 11, 2013
PubMed

Insights

Duodenal fold scalloping on esophagogastroduodenoscopy (EGD) is a strong indicator for celiac disease (CD) in children. Observing scalloping during EGD significantly increases the likelihood of a CD diagnosis, aiding clinicians in identifying the condition.

Area of Science:

  • Pediatric Gastroenterology
  • Gastrointestinal Endoscopy
  • Celiac Disease Diagnosis

Background:

  • Scalloping of duodenal folds during esophagogastroduodenoscopy (EGD) is linked to various conditions, including celiac disease (CD).
  • Understanding the frequency and diagnostic utility of scalloping in children is crucial for accurate celiac disease diagnosis.

Purpose of the Study:

  • To determine the frequency of duodenal fold scalloping in pediatric patients undergoing EGD.
  • To assess the significance of scalloping as a diagnostic marker for celiac disease in children.
  • To evaluate the association of scalloping with histopathology and serology in pediatric celiac disease patients.

Main Methods:

  • Retrospective analysis of 623 children (0-18 years) who underwent EGD over a 2.5-year period.
  • Data collection included patient files, focusing on EGD findings, histopathology, and celiac serology.
  • No selection bias was introduced in the consecutive cohort analysis.

Main Results:

  • Scalloping was observed in 12% of pediatric EGDs, with a high specificity (99%) and positive predictive value (97%) for diagnosing CD.
  • The prevalence of scalloping increased with the severity of Marsh classification in celiac disease patients (33% in Marsh 1 to 63% in Marsh 3c).
  • Scalloping was significantly associated with higher median tissue transglutaminase levels in celiac disease patients.

Conclusions:

  • Isolated duodenal fold scalloping during EGD strongly suggests celiac disease in pediatric patients.
  • Attention to duodenal fold scalloping can serve as a valuable additional tool in the diagnostic process for celiac disease.
  • This finding enhances the diagnostic accuracy of EGD for identifying celiac disease in children.
Abstract

Keywords:
celiac diseaseesophagogastroduodenoscopyscalloping

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