Celiac Disease and Gluten-Free Diet Support
- Questions? Join our forum: Nearly 1 MILLION POSTS, and over 62,000 MEMBERS!
Follow / Share
|Get Email Alerts|
- Safe Gluten-Free Food List (Safe Ingredients)
- Unsafe Gluten-Free Food List (Unsafe Ingredients)
- Gluten-Free Alcoholic Beverages
- Celiac Disease Symptoms
- The Gluten-Free Diet 101 - A Beginner's Guide to Going Gluten-Free
- Interpretation of Celiac Disease Blood Test Results
- Is Buckwheat Flour Really Gluten-Free?
Variability of Histopathological Changes in Childhood Celiac Disease
Celiac.com 11/18/2009 - Clinical studies of adults with celiac disease have shown that duodenal mucosal histopathological changes may be patchy, and the diagnostic value of duodenal bulb biopsies is thought to be limited. Very little data exist regarding how this applies to children with celiac disease.
A team of researchers recently set out to assess the prevalence of variable biopsy findings and duodenal bulb involvement in children with celiac disease, as well as its association with clinical parameters.
The research team was made up of Dascha C. Weir MD, Jonathan N. Glickman MD, Tracey Roiff, Clarissa Valim MD, ScD, and Alan M. Leichtner MD. The team analyzed the prevalence of variable biopsy findings and duodenal bulb involvement in children with celiac disease, together with its association with clinical parameters.
They looked at a total of 198 consecutive cases of celiac disease diagnosed at the Children’ s Hospital from 2001 to 2005. The team scored all biopsies using the Marsh criteria applied by a pathologist blinded to the clinical data.
The researchers categorized mucosal changes as 'focal' if changes consistent with celiac disease and normal mucosa were found within a single biopsy fragment. They defined 'patchiness' as variation of at least one Marsh grade between separate fragments in a biopsy set. The median patient age was 9.3 years; 62% were female.
The researchers took more than 700 biopsy samples, an average of 3.6 per patient. In 101 cases, they took biopsy sample from both the duodenal bulb and the second portion of the duodenum.
They classified 36 biopsy samples (18%) as focal. They classified 105 samples (53%) as 'patchy', with at least 1 normal biopsy fragment was present in 71 cases (36 %). In 10 cases, researchers made reliable diagnosis only via bulb biopsy. There was no association with the clinical features examined.
The research team concluded that duodenal involvement in childhood celiac disease is often patchy and may show variable severity even within a single biopsy fragment not reliably predicted by clinical characteristics. To maximize diagnostic yield, they recommend taking multiple endoscopic biopsies, including the duodenal bulb, in suspected cases of pediatric celiac disease.
Celiac.com welcomes your comments below (registration is NOT required).
Adherence to Biopsy Guidelines Increases Celiac Disease Diagnosis
A duodenal biopsy during endoscopy is the gold standard for diagnosing celiac disease.... [READ MORE]
Do Vitamin Supplements Benefit Celiac Patients?
A recent study confirms that B-vitamin supplements are helpful in raising vitamin B6, B12 and folate levels and in reducing homocysteine levels in people with celiac disease.... [READ MORE]
Small Drug Firm Announces Completion of First Human Trial for AT-1001 and FDA 'Fast Track' Designation for Possible Future Celiac Disease Treatment
Alba Therapeutics Corporation
(Alba) today announced successful completion of its first
Phase I trial for the drug candidate AT-1001, and that the FDA has granted
Fast Track designation to AT-1001 for treatment of celiac
disease.... [READ MORE]
Antacids May Trigger Food Allergies
According to Dr.... [READ MORE]
Jefferson Adams is a freelance writer living in San Francisco. His poems, essays and photographs have appeared in Antioch Review, Blue Mesa Review, CALIBAN, Hayden's Ferry Review, Huffington Post, the Mississippi Review, and Slate among others.
He is a member of both the National Writers Union, the International Federation of Journalists, and covers San Francisco Health News for Examiner.com.View all articles by Jefferson Adams
In Celiac.com's Forum Now:
Celiac.com Celiac Disease & Gluten-Free Diet Forum - All Activity