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Flattened Villi is Not Always Caused by Celiac Disease
In 1994 I was diagnosed with celiac disease, which led me to create Celiac.com in 1995. I created this site for a single purpose: To help as many people as possible with celiac disease get diagnosed so they can begin to live happy, healthy gluten-free lives. Celiac.com was the first site on the Internet dedicated solely to celiac disease. In 1998 I foundedÂ The Gluten-Free Mall, Your Special Diet Superstore!, and I am the co-author of the book Cereal Killers, and founder and publisher of Journal of Gluten Sensitivity.View all articles by Scott Adams
Celiac.com 04/20/2004 – According to researchers at the Department of Anatomic Pathology, William Beaumont Hospital, Royal Oak, MI, the cause of flattened villi is not always celiac disease. The researchers studied seven patients who experienced several weeks of gluten-sensitivity and the same type of villi injury—"increased lymphoplasmacytic lamina propria inflammation, moderate to complete villous flattening, numerous crypt mitoses, and markedly increased villous intraepithelial lymphocytes (IELs)." All patients were diagnosed with gluten sensitivity, and all returned 9 to 38 weeks later questioning their diagnosis, as their symptoms had substantially or completely disappeared, and clinical improvement in these patients seemed unrelated to their ingestion of gluten. A follow up endoscopy and colonoscopy was performed on these patients 4 to 16 months later, and the results of each showed a normal mucosa.
According to the researchers:
"Diseases other than GS can cause marked villous flattening and increased villous IELs in adults. The cause of small bowel mucosal injury is unknown. A similar non-GS-associated clinicopathologic complex, assumed to be due to a protracted viral enteritis or slow regression of a virus-induced immune reaction, occurs in children. The temporal aspects of symptom improvement and mucosal restitution in these 7 patients are similar to acute self-limited colitis. An overly exuberant immune response to an infectious agent is possible."
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