Role of magnification endoscopy in the diagnosis and evaluation of suspected celiac disease: correlation with histology.

BACKGROUND Magnification endoscopy (ME), with 115-fold magnification, allows visualization of duodenal villi. We assessed the efficacy of ME for evaluation of villous atrophy. METHODS ME and duodenal biopsy were done in 16 patients with suspected celiac disease and 16 control subjects undergoing endoscopy for reflux symptoms. The pathologist was unaware of the ME findings. RESULTS Sensitivity, specificity and positive and negative predictive values for villous atrophy (partial or total) were 100%, 91%, 83% and 100%, respectively. Corresponding values for normal villous structure were 91%, 100%, 100% and 83%, respectively. There was significant concordance between the ME and histology findings. CONCLUSION ME is a reliable technique to diagnose villous atrophy.