Resumo

ROSA, Bruno; MOREIRA, Maria João; REBELO, Ana  e  COTTER, José. Diagnosis of Crohn’s disease by capsule enteroscopy: is there a role for Lewis Score in clinical practice?. J Port Gastrenterol. [online]. 2010, vol.17, n.6, pp.248-254. ISSN 0872-8178.

INTRODUCTION: Suspected Crohn’s Disease (CD) is a common indication for capsule enteroscopy (CE). However, lesions are nonspecific and no gold standard is available for diagnosing CD. Lewis Score (LS) measures inflammatory activity based on oedematous villous appearance, ulcers and stenoses. AIM: To evaluate the role of SL in the diagnosis of CD in clinical practice. METHODS: Thirty patients who underwent CE for suspected CD were included and followed up for at least six months. Inflammatory activity was classified in three levels: clinically insignificant (score<135), mild (135≤score≤790) or moderate to severe (score > 790). RESULTS: Diagnosis of CD was established in 10 patients (33%). Clinically significant inflammatory activity (score ≥ 135) had a Positive Predictive Value (VPP) = 75%, Negative Predictive Value (VPN) = 94%, Sensitivity (S) = 90% and Specificity (E) = 85% for the diagnosis of CD. CONCLUSIONS: LS seems to be a useful index in the setting of suspected CD, increasing the objectivity of CE findings; it also has a good correlation with the diagnosis established during follow-up.

Palavras-chave : Crohn’s disease; enteroscopy; endoscopic capsule.

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