Peer-reviewed veterinary case report
Duodenal endoscopy helps diagnose intestinal lymphangiectasia in dogs
By Larson, R N et al.·Published in Journal of veterinary internal medicine·2012·Department of Medical Sciences, United States·View original on PubMed →
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Original publication title: Duodenal endoscopic findings and histopathologic confirmation of intestinal lymphangiectasia in dogs.
- Species:
- dog
Plain-English summary
A group of 51 dogs underwent upper gastrointestinal endoscopy to investigate intestinal lymphangiectasia (IL), a condition that can cause digestive issues. The endoscopic images of the duodenum were assessed to see how well they could predict IL, but the results showed that while the images had some accuracy, they weren't very reliable on their own. In fact, only about 68% of the cases were correctly identified, and the images were not specific enough to confirm the diagnosis without further testing. Ultimately, histopathologic confirmation (tissue analysis) was necessary for a definitive diagnosis.
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Abstract
BACKGROUND: The diagnosis of intestinal lymphangiectasia (IL) has been associated with characteristic duodenal mucosal changes. However, the sensitivity and specificity of the endoscopic duodenal mucosal appearance for the diagnosis of IL are not reported. HYPOTHESIS/OBJECTIVES: To evaluate the utility of endoscopic images of the duodenum for diagnosis of IL. Endoscopic appearance of the duodenal mucosal might predict histopathologic diagnosis of IL with a high degree of sensitivity and specificity. ANIMALS: 51 dogs that underwent upper gastrointestinal (GI) endoscopy and endoscopic biopsies. METHODS: Retrospective review of images acquired during endoscopy. Dogs were included if adequate biopsies were obtained during upper GI endoscopy and digital images were saved during the procedure. Images were assessed for the presence and severity of IL. Using histopathology as the gold standard, the sensitivity and specificity of endoscopy for diagnosing IL were calculated. RESULTS: Intestinal lymphangiectasia (IL) was diagnosed in 25/51 dogs. Gross endoscopic appearance of the duodenal mucosa had a sensitivity and specificity (95% confidence interval) of 68% (46%, 84%) and 42% (24%, 63%), respectively for diagnosis of IL. Endoscopic images in cases with lymphopenia, hypocholesterolemia, and hypoalbuminemia had a sensitivity of 80%. CONCLUSIONS AND CLINICAL IMPORTANCE: Endoscopic duodenal mucosa appearance alone lacks specificity and has only a moderate sensitivity for diagnosis of IL. Evaluation of biomarkers associated with PLE improved the sensitivity; however, poor specificity for diagnosis of IL supports the need for histopathologic confirmation.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/22827501/