TITLE

DOES ADOPTION OF BSG GUIDELINES FOR MANAGEMENT OF IRON DEFICIENCY ANAEMIA (IDA) RESULT IN AN INCREASE IN UNNECESSARY DUODENAL BIOPSIES?

AUTHOR(S)
Ferguson, H.R.; Sommerville, J.; Murphy, P.
PUB. DATE
April 2003
SOURCE
Gut;Apr2003 Supplement 1, Vol. 52, pA99
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Introduction: The British Society of Gastroenterology guidelines for the management of IDA suggest that duodenal biopsy should be done as a routine at the time of OGD in all patients. These guidelines were adopted in our trust but there was concern that they may increase the workload of an already stretched histopathology service, without o significant increase in the rate of diagnosis of coeliac disease. Aim: To determine the number of: duodenal biopsies performed annually and the rate of diagnosis of coeliac disease, before and after publication of the BSG guidelines. Methods: The histopathology laboratory indentified all patients who had a duodenal biopsy performed from April 1998 to April 1999, and April 2001 to April 2002. Reports were reviewed and data collected included patient demographics, consultant requesting biopsy, indication, and result. Results: 118 patients had duodenal biopsies performed in the year before adoption of the BSG guidelines. Mean age 49.3 years (range 4-86 years). 56% were female. 70% were referred by physicians, the remainder by surgeons. IDA was the indication in 30 patients (25%). 77 patients (65%) had a normal biopsy and 17 (14%) were diagnosed with coeliac disease. In the year after adoption of the guidelines, 196 patients had duodenal biopsies performed. Over this time period there was no significant change in referring clinicians or laboratory catchment population. Mean age 51.1 years (range 5-89 years). 78% were female, 75% referred by physicians. The indication was IDA in 46 patients (23%). 134 (68%) had a normal biopsy and 33 (17%) hod a diagnosis of coeliac disease made. Conclusion: The number of duodenal biopsies substantially increased after implementation of the guidelines, however this was not primarily due to a large increase in biopsies for IDA. Furthermore this increase was accompanied by an increase in the rate of diagnosis of coeliac disease. Implementation of the BSG guidelines has not been associated with...
ACCESSION #
9747957

 

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