Jump to content
This site uses cookies. Continued use is acceptance of our Terms of Use and Privacy Policy. More Info... ×
  • Welcome to Celiac.com!

    You have found your celiac tribe! Join us and ask questions in our forum, share your story, and connect with others.




  • Celiac.com Sponsor (A1):



    Celiac.com Sponsor (A1-M):


  • Get Celiac.com Updates:
    Support Our Content
    eNewsletter
    Donate
  • Jefferson Adams
    Jefferson Adams

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

    Reviewed and edited by a celiac disease expert.
    Can Celiac-related Enteropathies be Diagnosed without Detailed Grading of Villous Atrophy? - Is detailed grading of villous atrophy required to diagnose enteropathy? Photo: CC--Barry Stock
    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.

    Celiac.com Sponsor (A12):
    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:



    User Feedback

    Recommended Comments

    There are no comments to display.



    Create an account or sign in to comment

    You need to be a member in order to leave a comment

    Create an account

    Sign up for a new account in our community. It's easy!

    Register a new account

    Sign in

    Already have an account? Sign in here.

    Sign In Now

  • Get Celiac.com Updates:
    Support Celiac.com:
    Donate
  • 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. His articles, essays, poems, stories and book reviews have appeared in numerous magazines, journals, and websites, including North American Project, Antioch Review, Caliban, Mississippi Review, Slate, and more. He is the author of more than 2,500 articles on celiac disease. His university coursework includes studies in science, scientific methodology, biology, anatomy, physiology, medicine, logic, and advanced research. He previously devised health and medical content for Colgate, Dove, Pfizer, Sharecare, Walgreens, and more. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of numerous books, including "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

    >VIEW ALL ARTICLES BY JEFFERSON ADAMS

     


  • Celiac.com Sponsor (A17):
    Celiac.com Sponsor (A17):





    Celiac.com Sponsors (A17-M):




  • Related Articles

    Jefferson Adams
    What if I Have Villous Atrophy but Negative Celiac Blood Tests?
    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 manage cases of unclassified sprue.
    To get a better picture of this dilemma, a team of researchers recently examined the connections between villous atrophy and negative celiac serology.
    The research team included M. Degaetani, C.A. Tennyson, B. Lebwohl, S.K. Lewis, H. Abu Daya, C. Arguelles-Grande, G. Bhagat G, and P.H. Green. They are variously affiliated with the Celiac Disease Center, and the Department...


    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 biopsy specimens obtained with the single-biopsy and double-biopsy techniques.
    The research team includes M. Latorre, S.M. Lagana, D.E. Freedberg, S.K. Lewis, B. Lebwohl, G. Bhagat, and P. H. Green of the Celiac Disease Center, Department of Medicine, Columbia University, New York, New York, USA.
    Their prospective cohort study looked at patients undergoing upper endoscopy with confirmed, suspected, or unknown...


    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 questioned the diagnosis, because the woman showed no clinical or histological improvement after a long period of strict gluten-free diet.
    The research team included U Volta, MG Mumolo, G Caio, E Boschetti, R Latorre, F Giancola, P Paterini, and R De Giorgio. They variously are affiliated with the Department of Medical and Surgical Sciences at the University of Bologna, and with the Gastroenterology Unit in the...


    Jefferson Adams
    What Can 30 Years of Duodenal Biopsies Tell Us About Celiac Disease?
    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 in Vancouver, British Columbia, recently set out to review the detection of adult celiac disease using duodenal screening biopsies over a 30-year period.
    Dr. Freeman reviewed data from patients referred between January 1982 and December 2011 for evaluation of gastrointestinal symptoms, requiring elective investigative upper endoscopic evaluation, and who underwent duodenal biopsies to determine whether changes...


  • Recent Activity

    1. - Wheatwacked replied to Dhruv's topic in Celiac Disease Pre-Diagnosis, Testing & Symptoms
      20

      Confused with test results

    2. - trents replied to Elliebee's topic in Celiac Disease Pre-Diagnosis, Testing & Symptoms
      12

      Does Hashimoto’s Hypothyroidism elevate Ttg levels ? I have had 3 blood test results where ttg levels are around 39-43 (range 0-19). The first test was in 2021 before I was diagnosed with autoimmune thyroid disease. I had an endos

    3. - Elliebee replied to Elliebee's topic in Celiac Disease Pre-Diagnosis, Testing & Symptoms
      12

      Does Hashimoto’s Hypothyroidism elevate Ttg levels ? I have had 3 blood test results where ttg levels are around 39-43 (range 0-19). The first test was in 2021 before I was diagnosed with autoimmune thyroid disease. I had an endos

    4. - Scott Adams replied to Elliebee's topic in Celiac Disease Pre-Diagnosis, Testing & Symptoms
      12

      Does Hashimoto’s Hypothyroidism elevate Ttg levels ? I have had 3 blood test results where ttg levels are around 39-43 (range 0-19). The first test was in 2021 before I was diagnosed with autoimmune thyroid disease. I had an endos

    5. - trents replied to Elliebee's topic in Celiac Disease Pre-Diagnosis, Testing & Symptoms
      12

      Does Hashimoto’s Hypothyroidism elevate Ttg levels ? I have had 3 blood test results where ttg levels are around 39-43 (range 0-19). The first test was in 2021 before I was diagnosed with autoimmune thyroid disease. I had an endos


  • Celiac.com Sponsor (A19):



  • Member Statistics

    • Total Members
      125,778
    • Most Online (within 30 mins)
      7,748

    Cathy Roth
    Newest Member
    Cathy Roth
    Joined

  • Celiac.com Sponsor (A20):


  • Forum Statistics

    • Total Topics
      120.8k
    • Total Posts
      68.9k

  • Celiac.com Sponsor (A22):





  • Celiac.com Sponsor (A21):



  • Popular Now

    • Elliebee
    • mswhis
    • Dhruv
      20
    • Sking
    • jmiller93
      8
  • Popular Articles

    • Scott Adams
    • Scott Adams
    • Scott Adams
    • Scott Adams
    • Scott Adams
  • Upcoming Events

×
×
  • Create New...