Jump to content

Follow Us:  Twitter Facebook RSS Feed            




   arrowShare this page:
   

   Get email alerts  Subscribe to FREE Celiac.com email alerts

 
Celiac.com Sponsor:                                    


Photo
- - - - -

Nonceliac Gluten Intolerance - Follow Up Care?


  • Please log in to reply

15 replies to this topic

#16 IrishHeart

 
IrishHeart

    Warrior Princess

  • Advanced Members
  • PipPipPipPipPipPip
  • 10,558 posts
 

Posted 16 January 2013 - 04:35 PM

The modified Marsh classification of gluten-induced small-intestinal damage has been updated as of April 2012

Stage 0 Preinfiltrative mucosa; up to 30% of patients with dermatitis herpetiformis (DH) or
gluten ataxia have small-intestinal biopsy specimens that appear normal
Stage 1 Increase in the number of intraepithelial lymphocytes (IELs) to more than 30 per
100 enterocytes
Stage 2 Crypt hyperplasia. In addition to the increased IELs, there is an increase in crypt
depth without a reduction in villus height. Gluten challenge can induce these
changes, which can also be seen in 20% of untreated patients with dermatitis
herpetiformis and celiac disease
Stage 3 Villous atrophy: A, partial; B, subtotal; C, total. This is the classic celiac lesion. It
is found in 40% of DH patients. Despite marked mucosal changes, many
individuals are asymptomatic and therefore classified as having subclinical or
silent cases. This lesion is characteristic of, but not diagnostic of, celiac disease
and can also be seen with severe giardiasis, infantile food sensitivities, graftversus-
host disease, chronic ischemia of the small intestine, tropical sprue,
immunoglobulin deficiencies, and other immune deficiencies and allograft
rejection


This is why diagnosis of celiac is based on several criteria, not just one.

http://www.worldgast..._long_FINAL.pdf


also:


".... Instead we find clinically useful the shifting to a quantitative approach that can be defined as the "4 out of 5" rule: the diagnosis of celiac disease is confirmed if at least 4 of the following 5 criteria are satisfied: typical symptoms of celiac disease; positivity of serum celiac disease immunoglobulin, A class autoantibodies at high titer; human leukocyte antigen (HLA)-DQ2 or DQ8 genotypes; celiac enteropathy at the small bowel biopsy; and response to the gluten-free diet."

http://www.ncbi.nlm....pubmed/20670718

  • 0

"Life is not the way it's supposed to be. It's the way it is. The way we cope with it makes the difference." Virginia Satir

"The strongest of all warriors are these two - time and patience." Leo Tolstoy

"If you want to lift yourself up, lift up someone else" Booker T. Washington

“If idiots could fly, the sky would be like an airport.”― Laura Davenport 

"Do or do not. There is no try. "-  Yoda.

"LTES"  Gem 2014

 

Misdiagnosed for 25+ years; Finally Diagnosed with Celiac  11/01/10.  Double DQ2 genes. This thing tried to kill me. I view Celiac as a fire breathing dragon --and I have run my sword right through his throat.
I. Win. bliss-smiley-emoticon.gif


Celiac.com Sponsor:



0 user(s) are reading this topic

0 members, 0 guests, 0 anonymous users

Celiac.com Sponsors: