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Crohn’s Disease Only Visible on Small Bowel Capsule Endoscopy: A New Entity

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A Correction to this article was published on 25 September 2020

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Abstract

Background and Aims

In rare cases, the diagnosis of Crohn’s disease (CD) can only be achieved using small bowel capsule endoscopy (SBCE). We investigate the characteristics of patients with CD only visible on SBCE and assess their disease course.

Methods

Data of all adult patients with confirmed CD diagnosis based on SBCE with normal endoscopic and cross-sectional imaging findings were retrospectively collected in three tertiary-level hospitals from January 2014 to March 2020.

Results

Thirteen patients were included. Ten patients were females, and the mean age at diagnosis was 36 years. Ileum was mostly involved (85%), while duodenum and jejunum were affected in 23% and 38% of the cases, respectively. Nine patients had one segment involved, while four subjects had two or three segments affected. All patients had inflammatory behavior. First treatment consisted of steroids in all cases, and six patients were later treated with immunosuppressant or biologics. After a mean follow-up of 27.5 months, no change in disease behavior, hospitalization, or CD-related surgery was observed.

Conclusions

CD only visible at SBCE is a rare condition with a more favorable disease course compared to general CD with a lower rate of complicated behavior, hospitalization, and surgery, despite a similar use of immunosuppressant or biologics.

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Change history

Abbreviations

CD:

Crohn’s disease

IBD:

Inflammatory bowel disease

CTE:

Computed tomography enterography

MRE:

Magnetic resonance enterography

US:

Ultrasonography

SBCE:

Small bowel capsule endoscopy

EIMs:

Extra-intestinal manifestations

CECDAI:

Capsule Endoscopy Crohn’s Disease Activity Index

CRP:

C-reactive protein

FC:

Fecal calprotectin

TNF:

Tumor necrosis factor

IMIDS:

Immune-mediated inflammatory disease

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Funding

No funding was received for the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Hepato-Gastroenterology, University Hospital of Grenoble, University of Grenoble Alpes, Grenoble, France

    Thomas Chateau & Nicolas Mathieu

  2. Department of Gastroenterology and Inserm U1256 NGERE, University Hospital of Nancy, University of Lorraine, 1 Allée du Morvan, 54511, Vandoeuvre-lès-Nancy, France

    Thomas Chateau, Ferdinando Damico, Camille Zallot & Laurent Peyrin-Biroulet

  3. Department of Biomedical Sciences, Humanitas University, Milan, Italy

    Ferdinando Damico

Authors
  1. Thomas Chateau
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  4. Nicolas Mathieu
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  5. Laurent Peyrin-Biroulet
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Contributions

TC collected the data, wrote the first draft of the article, created tables and figures, and contributed to the editing. FD collected the data and contributed to the editing. CZ and NM contributed to the editing and revised the article for important intellectual content. LPB contributed to editing of the manuscript and supervised the work.

Corresponding author

Correspondence to Laurent Peyrin-Biroulet.

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Conflict of interest

TC, FD, CZ, and NM have no conflict of interest to disclose. LPB reports personal fees from AbbVie, Janssen, Genentech, Ferring, Tillots, Pharmacosmos, Celltrion, Takeda, Boerhinger Ingelheim, Pfizer, Index Pharmaceuticals, Sandoz, Celgene, Biogen, Samsung Bioepis, Alma, Sterna, Nestle, Enterome, Allergan, MSD, Roche, Arena, Gilead, Hikma, Amgen, BMS, Vifor, Norgine; Mylan, Lilly, Fresenius Kabi, Oppilan Pharma, Sublimity Therapeutics, Applied Molecular Transport, OSE Immunotherapeutics, Enthera, Theravance; grants from AbbVie, MSD, Takeda; stock options: CTMA.

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Chateau, T., Damico, F., Zallot, C. et al. Crohn’s Disease Only Visible on Small Bowel Capsule Endoscopy: A New Entity. Dig Dis Sci 66, 2712–2716 (2021). https://doi.org/10.1007/s10620-020-06553-3

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  • DOI: https://doi.org/10.1007/s10620-020-06553-3

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