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Small-bowel capsule endoscopy in patients with iron-deficiency anemia

The latest issue of Gastrointestinal Endoscopy evaluates the diagnostic yield of small-bowel capsule endoscopy in patients with iron-deficiency anemia.

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Iron-deficiency anemia is the most common cause of anemia worldwide.

Current guidelines recommend the use of small-bowel capsule endoscopy in iron-deficiency anemia.

Evidence of the validity of small-bowel capsule endoscopy in patients with iron-deficiency anemia alone is still limited.

Dr Anastasios Koulaouzidis and colleagues from the United Kingdom assessed the diagnostic yield of small-bowel capsule endoscopy in iron-deficiency anemia by pooling data from relevant studies.

The research team identified studies that estimated the diagnostic yield of small-bowel capsule endoscopy in iron-deficiency anemia.

The pooled diagnostic yield of small-bowel capsule endoscopy in iron-deficiency anemia was 47%
Gastrointestinal Endoscopy

There were 2 investigators that independently conducted the search and data extraction.

A total of 24 studies enrolling 1960 patients with iron-deficiency anemia who underwent small-bowel capsule endoscopy were included.

The team's main outcome measurements included per-patient diagnostic yield, with 95% confidence intervals.

Subgroup analysis was also performed.

The researchers' pooled diagnostic yield of small-bowel capsule endoscopy in iron-deficiency anemia, evaluated by a random-effects model, was 47%, but there was statistically significant heterogeneity among the included studies.

The team noted that the pooled diagnostic yield of small-bowel capsule endoscopy in studies focused solely on patients with iron-deficiency anemia was 67%, conversely, that of studies not focusing only on iron-deficiency anemia patients was 44%.

In particular, more vascular, inflammatory, and mass/tumor lesions were detected with small-bowel capsule endoscopy in patients participating in the studies in subset 1.

Dr Anastasios' team concludes, "This analysis demonstrates the validity of small-bowel capsule endoscopy in the investigation of patients with iron-deficiency anemia and negative findings on a previous diagnostic workup, although certain factors such as heterogeneity and quality of the included studies should be taken into account."

Gastrointest Endoscopy 2012: 76(5): 983-992
19 November 2012

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