Lily McGuinn1, Crystal Hermosura1, Jessica Roache1 and Paul H Hartel MD2*
1Atlantic Technological University, Ireland 2Sligo University Hospital, Ireland
1Atlantic Technological University, Ireland
2Sligo University Hospital, Ireland
*Corresponding Author: Paul H Hartel MD, Sligo University Hospital, Ireland.
Received: August 01, 2023; Published: August 07, 2023
To evaluate the prevalence of classic histopathologic findings in serologic antibody-positive coeliac disease patients, we reviewed histology from duodenal biopsies in 20 tissue transglutaminase antibody-positive (IgA Anti-tTG) cases. Classic triad of increased intraepithelial lymphocytes, blunted villi and crypt hyperplasia were seen in only approximately one third of cases. Increased intraepithelial lymphocytes and villous blunting were more prevalent, and one fifth of cases had only increased intraepithelial lymphocytes. Villous blunting alone and histologically normal biopsies were much less common. Many patients with positive coeliac antibody serology do not show the classic triad of histologic findings. Any one of the three should allow for coeliac serologic antibody testing, if this has not already been done. Classic histology may be limited to proximal duodenum. Endoscopic biopsies should include multiple duodenal biopsies including bulb, and first (D1), second (D2) and third parts of duodenum (D3) to increase diagnostic sensitivity.
Keywords: Coeliac Disease; Increased Intraepithelial Lymphocytes; Villous Blunting; Duodenal Biopsy
Citation: Paul H Hartel MD., et al. “Non-classic Histology in Coeliac Disease and Implications for Clinical Management". Acta Scientific Gastrointestinal Disorders 6.9 (2023): 11-13.
Copyright: © 2023 Paul H Hartel MD., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.