Reviewer's report
Title:Diagnosing celiac disease by video capsule endoscopy (VCE) when
esophogastroduodenoscopy (EGD) and biopsy is unable to provide a diagnosis:
A case series
Version: 2Date:6 May 2012
Reviewer: Georgia G Malamut
Reviewer's report:
M. Chang et al report an interesting case series of eight patients investigated for
celiac disease and treated by a gluten free diet basing on capsule endoscopy
reports without histological proof. Some points should be precised and other
possible causes of villous atrophy need to be discussed.
Major Points
• Patients & Methods: how many patients with a possible celiac disease did the
authors screen? Please precise the time period of recording. How many these 8
patients represent among all the suspected celiac patients investigated in this
tertiary care center in USA?
• Please precise the type of autoantidodies: anti-gliadin IgA or IgG? Anti-TTG IgA
or IgG?
• Was the dosage of total and subtypes of immunoglobulins (IgA, IgG, IgM)
performed, particularly in patients 3 and 4?
• Were the other causes of villous atrophy excluded such as autoimmune
enteropathy with the dosage of anti-enterocytes or anti-AIE 75KD antibodies?
Indeed positive celiac antibodies may be observed in patients with autoimmune
enteropathy (Akram S, Murray JA, Pardi DS, et al. Adult autoimmune
enteropathy: Mayo Clinic Rochester experience. Clin Gastroenterol Hepatol
2007;5:1282-90).
• Please, indicate the HLA-type II for each patient. Had all the patients the
celiac-susceptibility HLA DQ2/DQ8 genotype?
• How many duodenal biopsies have been performed in each case?
• Have been some patients investigated by a second endoscopy with biopsy, 6
months or 1 year later to check histology before beginning the gluten free diet?
• Did some patients have a control capsule endoscopy under gluten free diet to
check villous recovery?
Minor points
* Please precise the delay of gluten free diet and the time of evaluation for each
patient. These data including possible changes in celiac antibodies levels, control
capsule endoscopy and biopsy could be included in a second Table "Response
to a Gluten free diet"
* Capsule endoscopy images of the eight patients should be given in a composite
figure.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I am co-author of a review on refractory celiac disease in a chapter book treating
of celiac disease coordinated by Peter H. Green. This review is not yet published.
I have no financial competing interest.
Reviewer's report
Title:Diagnosing celiac disease by video capsule endoscopy (VCE) when
esophogastroduodenoscopy (EGD) and biopsy is unable to provide a diagnosis:
A case series
Version: 2Date:6 May 2012
Reviewer: Georgia G Malamut
Reviewer's report:
M. Chang et al report an interesting case series of eight patients investigated for
celiac disease and treated by a gluten free diet basing on capsule endoscopy
reports without histological proof. Some points should be precised and other
possible causes of villous atrophy need to be discussed.
Major Points
• Patients & Methods: how many patients with a possible celiac disease did the
authors screen? Please precise the time period of recording. How many these 8
patients represent among all the suspected celiac patients investigated in this
tertiary care center in USA?
• Please precise the type of autoantidodies: anti-gliadin IgA or IgG? Anti-TTG IgA
or IgG?
• Was the dosage of total and subtypes of immunoglobulins (IgA, IgG, IgM)
performed, particularly in patients 3 and 4?
• Were the other causes of villous atrophy excluded such as autoimmune
enteropathy with the dosage of anti-enterocytes or anti-AIE 75KD antibodies?
Indeed positive celiac antibodies may be observed in patients with autoimmune
enteropathy (Akram S, Murray JA, Pardi DS, et al. Adult autoimmune
enteropathy: Mayo Clinic Rochester experience. Clin Gastroenterol Hepatol
2007;5:1282-90).
• Please, indicate the HLA-type II for each patient. Had all the patients the
celiac-susceptibility HLA DQ2/DQ8 genotype?
• How many duodenal biopsies have been performed in each case?
• Have been some patients investigated by a second endoscopy with biopsy, 6
months or 1 year later to check histology before beginning the gluten free diet?
• Did some patients have a control capsule endoscopy under gluten free diet to
check villous recovery?
Minor points
* Please precise the delay of gluten free diet and the time of evaluation for each
patient. These data including possible changes in celiac antibodies levels, control
capsule endoscopy and biopsy could be included in a second Table "Response
to a Gluten free diet"
* Capsule endoscopy images of the eight patients should be given in a composite
figure.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I am co-author of a review on refractory celiac disease in a chapter book treating
of celiac disease coordinated by Peter H. Green. This review is not yet published.
I have no financial competing interest.
Please review this paper.
user
Reviewer's report
Title:Diagnosing celiac disease by video capsule endoscopy (VCE) when
esophogastroduodenoscopy (EGD) and biopsy is unable to provide a diagnosis:
A case series
Version: 2Date:6 May 2012
Reviewer: Georgia G Malamut
Reviewer's report:
M. Chang et al report an interesting case series of eight patients investigated for
celiac disease and treated by a gluten free diet basing on capsule endoscopy
reports without histological proof. Some points should be precised and other
possible causes of villous atrophy need to be discussed.
Major Points
• Patients & Methods: how many patients with a possible celiac disease did the
authors screen? Please precise the time period of recording. How many these 8
patients represent among all the suspected celiac patients investigated in this
tertiary care center in USA?
• Please precise the type of autoantidodies: anti-gliadin IgA or IgG? Anti-TTG IgA
or IgG?
• Was the dosage of total and subtypes of immunoglobulins (IgA, IgG, IgM)
performed, particularly in patients 3 and 4?
• Were the other causes of villous atrophy excluded such as autoimmune
enteropathy with the dosage of anti-enterocytes or anti-AIE 75KD antibodies?
Indeed positive celiac antibodies may be observed in patients with autoimmune
enteropathy (Akram S, Murray JA, Pardi DS, et al. Adult autoimmune
enteropathy: Mayo Clinic Rochester experience. Clin Gastroenterol Hepatol
2007;5:1282-90).
• Please, indicate the HLA-type II for each patient. Had all the patients the
celiac-susceptibility HLA DQ2/DQ8 genotype?
• How many duodenal biopsies have been performed in each case?
• Have been some patients investigated by a second endoscopy with biopsy, 6
months or 1 year later to check histology before beginning the gluten free diet?
• Did some patients have a control capsule endoscopy under gluten free diet to
check villous recovery?
Minor points
* Please precise the delay of gluten free diet and the time of evaluation for each
patient. These data including possible changes in celiac antibodies levels, control
capsule endoscopy and biopsy could be included in a second Table "Response
to a Gluten free diet"
* Capsule endoscopy images of the eight patients should be given in a composite
figure.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I am co-author of a review on refractory celiac disease in a chapter book treating
of celiac disease coordinated by Peter H. Green. This review is not yet published.
I have no financial competing interest.
assistant