Jump to content
This site uses cookies. Continued use is acceptance of our Terms of Use. ×
  • Sign Up
Celiac.com Sponsor:

Celiac.com Sponsor:

  • Join Our Community!

    Get help in our celiac / gluten-free forum.

  • Jefferson Adams
    Jefferson Adams

    By Jefferson Adams •

    Can Celiac-related Enteropathies be Diagnosed without Detailed Grading of Villous Atrophy?

    Reviewed and edited by a celiac disease expert.

    Caption: Is detailed grading of villous atrophy required to diagnose enteropathy? Photo: CC--Barry Stock

    Celiac.com 01/09/2017 - Some researchers have criticized the usefulness of the 7 level Marsh-Oberhuber classification of mucosal damage in patients with celiac disease.

    Even though assessing duodenal biopsies with dissecting microscopy is a somewhat crude method, it can provide useful information in cases of obvious villous atrophy.

    For the past 15 years, one research team has analyzed duodenal biopsies with dissecting microscopy before sending them to the pathology department for histology. Their feeling is that, if dissecting microscopy and traditional histology were comparable, the grading of the histological lesion would be unnecessary, or even pointless, for proper diagnosis of most enteropathies.

    That research team recently set out to settle that question. The team included F Biagi, C Vattiato, M Burrone, A Schiepatti, S Agazzi, G Maiorano, O Luinetti, C Alvisi, C Klersy, and GR Corazza. They are variously affiliated with the First Department of Internal Medicine, the Biometry and Statistics, the Department of Pathology at University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; and with the Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy.

    They conducted a retrospective analysis of the clinical notes of all 2,075 patients undergoing duodenal biopsy between September 1999 and June 2015. They collected and statistically compared the results of duodenal mucosal evaluation with both dissecting microscopy and traditional histology.

    Their results, using κ statistics, showed a substantial agreement of the two methods (κ statistics 0.78). Sensitivity of dissecting microscopy for detection of severe villous atrophy was 85.1% (95% CI 81.2% to 88.5%) and specificity was 95% (95% CI 93.8% to 96%).

    Although dissecting microscopy is no substitute for traditional histology, these results suggest that most celiac disease-related and other flat enteropathies can be sufficiently diagnosed without grading villous atrophy.

    Source:

    Go to articles

    User Feedback

    Recommended Comments

    There are no comments to display.



    Join the conversation

    You are posting as a guest. If you have an account, sign in now to post with your account.
    Note: Your post will require moderator approval before it will be visible.

    Guest
    Add a comment...

    ×   Pasted as rich text.   Paste as plain text instead

      Only 75 emoji are allowed.

    ×   Your link has been automatically embedded.   Display as a link instead

    ×   Your previous content has been restored.   Clear editor

    ×   You cannot paste images directly. Upload or insert images from URL.

    ×

  • About Me

    Jefferson Adams

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,000 articles on celiac disease. His coursework includes studies in science, scientific methodology, biology, anatomy, medicine, logic, and advanced research. He previously served as SF Health News Examiner for Examiner.com, and devised health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

  • Related Articles

    Jefferson Adams
    Celiac.com 06/27/2013 - Patients with villous atrophy and negative celiac disease serologies pose a diagnostic and therapeutic dilemma.
    When doctors are unable to determine what is causing villous atrophy in a patient without celiac disease, they usually classify it as a case of "unclassified sprue." However, doctors currently know very little about the best way to treat and...
    Jefferson Adams
    Celiac.com 03/18/2015 - Getting high-quality biopsy specimens is key to making accurate celiac disease diagnoses. Endoscopists may take either a single- or double-biopsy specimen with each pass of the forceps.
    Does it matter whether they take one or two? Is two better than one?
    A team of researchers recently set out to answer those questions, by comparing the quality of...
    Jefferson Adams
    Celiac.com 06/08/2016 - Sometimes, certain cases can stand out and grab the attention of clinicians or researchers. Such is the case of a 62-year-old woman who was suffering from severe malabsorption, and diagnosed with celiac disease based on the findings of flat, small intestinal mucosa and HLA-DQ2 positivity, although celiac blood tests were negative.
    A team of researchers...
    Jefferson Adams
    Celiac.com 12/12/2016 - Studies suggest that celiac disease affects about 0.5% to 1% of the North American population. There is no good screening data based on small intestinal biopsy performed during routine endoscopic evaluation.
    Researcher Hugh James Freeman, MD CM FRCPC FACP, of the Gastroenterology unit in the Department of Medicine at the University of British Columbia...
  • Celiac.com Sponsor:

  • Forum Discussions
    Bshake

    Daily stomach pain and nauseated

    Hi ...my 19 year old daughter in January of 2019 started having stomach pain. Since we have had endoscopy and colonoscopy...in April it was determined she had a non functioning gall bladder and was removed, we were happy just knowing that...
    cyclinglady

    stool test postive twice

    About 30% or a bit more of the entire population has the celiac genes.  Only a tiny few actually develop celiac disease. The gene test just rules out celiac disease.   My advice is to find a medical doctor who is celiac savvy.  One th...
    kareng

    stool test postive twice

    I don’t know why you had a stool test instead of a blood test.  But taking the actual blood test for Celiac while gluten-free is not a good idea.  It tells you nothing.  If you have Celiac , and are eating gluten-free, you shouldn’t be mak...
×
×
  • Create New...