Aust. News story re: high powered microscope

[Lara]

This article was just released. I don't know anymore about this than what is on the news right now, but thought I'd post here for you all.

http://www.abc.net.au/news/newsitems/200610/s1762422.htm
ABC News, Australia.
Last Update: Wednesday, October 11, 2006. 3:03pm (AEST)
Doctors develop diagnostic technique for coeliac disease

Patients suspected of having coeliac disease can now have their diagnosis instantly confirmed.

The new technology means patients do not have to wait weeks before knowing if they have the condition.

Coeliac disease occurs when patients cannot break down gluten found in wheat and many other cereals.

Patients can suffer gastric symptoms and other conditions such as osteoporosis.

Until now doctors have had to do a blood test and then a biopsy to see if patients had the illness.

Australian doctors have developed a high powered microscope which magnifies the cells in the body 1000 times, allowing an instant diagnosis.

A study released today found the microscope was an accurate way to diagnose patients.

Doctors plan to use it to diagnose Crohns disease and early bowel cancer.

p.s. the spelling isn't an error, it's how we spell it. coeliac/celiac

[annelb]

This may be what they are talking about. It requres an endoscopy. The problem I see is that it is for diagnosing total villous atrophy. I don't see how it could pick up subtle changes of early CD. Heck, even biopsy examined by light microscopy does not pick up the changes that electron microscopy can. I hope the docs using this are still taking biopsies if they don't see total villous atrophy.

IMHO, waiting for total villous atrophy before diagnosing a problem with gluten is the same as waiting for the stroke or heart attack before treating high blood pressure.

If you go to the website you will find related articles. Interesting, all the articles are from Italy - didn't see any from Australia.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Search&db=pubmed&term=coeliac+immersion&tool=fuzzy&ot=coeliac+imersion


Aliment Pharmacol Ther. 2006 Jan 1;23(1):61-9.Click here to read Links
High accuracy and cost-effectiveness of a biopsy-avoiding endoscopic approach in diagnosing coeliac disease.

* Cammarota G,
* Cesaro P,
* Martino A,
* Zuccala G,
* Cianci R,
* Nista E,
* Larocca LM,
* Vecchio FM,
* Gasbarrini A,
* Gasbarrini G.

Department of Internal Medicine and Gastroenterology, Catholic University of Medicine and Surgery, Rome, Italy. gcammarota@rm.unicatt.it

BACKGROUND: The 'immersion' technique during upper endoscopy allows the visualization of duodenal villi and the detection of total villous atrophy. AIM: To evaluate the accuracy of the immersion technique in detecting total villous atrophy in suspected coeliac patients. The accuracy in diagnosing coeliac disease and the potential cost-sparing of a biopsy-avoiding approach, based on selection of individuals with coeliac disease-related antibodies and on endoscopic detection of absence of villi, were also analysed. METHODS: The immersion technique was performed in 79 patients with positive antibodies and in 105 controls. Duodenal villi were evaluated as present or absent. As reference, results were compared with histology. Diagnostic approaches, including endoscopy with or without biopsy, were designed to investigate patients with coeliac disease-related antibodies and total villous atrophy. A cost-minimization analysis was performed. RESULTS: All patients with positive antibodies had coeliac disease. The sensitivity, specificity, positive and negative predictive values of endoscopy to detect total villous atrophy was always 100%. The sensitivity, specificity, positive and negative predictive values of biopsy-avoiding or biopsy-including strategies in diagnosing coeliac disease when villi were absent was always 100%. The biopsy-avoiding strategy was cost-sparing. CONCLUSIONS: Upper endoscopy is highly accurate in detecting total villous atrophy coeliac patients. A biopsy-avoiding approach is both accurate and cost-sparing to diagnose coeliac disease in subjects with marked duodenal villous atrophy.

PMID: 16393281 [PubMed - indexed for MEDLINE]


Thank, Lara.
Anne

[jcc]

Thanks, Lara, for bringing this to us :).

The diagnostics are continously evolving in both methods and criteria. It is nice to stay up on the latest. This looks like a step forward in diagnosing 'celiac disease' with villous atrophy. It still ignores those of us with gluten sensitivity, but that is whole 'nother subject. Even though the biopsy is considered relatively 'safe', this would side step the cutting part at least (of course, other things may be determined by biopsy, like h. pylori)

Thanks again!

Cara

[annelb]

Here is another possibiltiy as to what this new procedure is. Confocal Laser Endomicroscopy http://www.endomicroscopy.org/ If you go into "Click to Enter" you will see some pictures and it talks about 1000 magnification.

Anne