No popular authors found.
Ads by Google:

Categories

No categories found.


Get Celiac.com's E-Newsletter





Ads by Google:


Follow / Share


  FOLLOW US:
Twitter Facebook Google Plus Pinterest RSS Podcast Email  Get Email Alerts
SHARE:

Popular Articles

No popular articles found.
Celiac.com Sponsors:

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.

Ads by Google:

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.

Source:
Am J Gastroenterol  6 October 2009; doi: 10.1038/ajg.2009.557

Celiac.com welcomes your comments below (registration is NOT required).












Related Articles



1 Response:

 
zubair

said this on
16 Nov 2011 9:01:19 AM PDT
My son is a celiac disease patient, according to this report anti tissue transglutaminase IGA result(s )units 174.5 u/ml and reference range is 0-10. I don't know that it is positive or not.




Rate this article and leave a comment:
Rating: * Poor Excellent
Your Name *: Email (private) *:




In Celiac.com's Forum Now:


I am confused too. I appears that your blood panel was indeterminate, but that your NP had you on a grain free diet for five weeks prior. You went back on gluten for two weeks (recommendation is 2 to 4) for the endoscopy. Maybe it was not enough time for your antibodies to build up and start a...

I looked at your past posts, but I?m not sure i know what you were eating then and what you?ve stopped eating now. Also what sort of medical workups you?ve had and what were the results. I understand your biopsy was negative - but I also saw on one post that you were worried they only took one bi...

I've posted a few different topics, so I thought I would just update in one post. I am seeing my GP later today, but apparently my biopsy results were negative. I have no further information on this. What I do know, is that I have been feeling much worse since giving up gluten after my gluten cha...

It doesn't change DH, but it always makes me smile thinking someone means Dear Husband instead of the rash.

It's done this since I started on here, many years ago. Kind of funny when people type g f meaning girlfriend...... ?