Magnetic resonance enterography in pediatric celiac disease (original) (raw)

Jornal de Pediatria, 2017

Abstract

To assess if magnetic resonance enterography (MRE) is capable of showing evidence/extent of disease in pediatric patients with biopsy-proven celiac disease (CD) by comparing with a control group, and to correlate the MRE findings with anti-endomysial antibody (EMA) level, which is an indicator of gluten-free dietary compliance. Thirty-one pediatric patients (mean age 11.7±3.1 years) with biopsy-proven CD and 40 pediatric patients as a control group were recruited in the study. The MRE images of both patients with CD and those of the control group were evaluated by two pediatric radiologists in a blinded manner for the mucosal pattern, presence of wall thickening, luminal distention of the small bowel, and extra-intestinal findings. Patient charts were reviewed to note clinical features and laboratory findings. The histopathologic review of the duodenal biopsies was re-conducted. The mean duration of the disease was 5.6±1.8 years (range: 3-7.2 years). In 24 (77%) of the patients, EMA levels were elevated (mean 119.2±66.6RU/mL). MRE revealed normal fold pattern in all the patients. Ten (32%) patients had enlarged mesenteric lymph nodes. Although a majority of the patients had elevated EMA levels indicating poor dietary compliance, MRE did not show any mucosal abnormality associated with the inability of MRE to detect mild/early changes of CD in children. Therefore, it may not be useful for the follow-up of pediatric CD.

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