Morphometric Evaluation of Duodenal Biopsies in Celiac Disease

Cummins, Adrian G.; Alexander, Basile G.; Chung, Adrian; Teo, Edward; Woenig, Josh A.; Field, John B. J.; Thompson, Fiona M.; Roberts-Thomson, Ian C.
January 2011
American Journal of Gastroenterology;Jan2011, Vol. 106 Issue 1, p145
Academic Journal
OBJECTIVES:The Marsh classification is a semiquantitative method for the diagnosis and monitoring of changes in duodenal biopsies in celiac disease. We have explored the possibility that quantitative changes in villous area and crypt length (morphometry) may provide better information on changes in duodenal morphology, particularly after the introduction of a gluten-free diet.METHODS:We measured villous height, apical and basal villous widths, and crypt length in 57 adults with celiac disease and 83 control subjects. Villous area was calculated as a trapezoid approximation. Serial changes in villous area and crypt length were determined at regular intervals for up to 4 years after the introduction of a gluten-free diet. Morphometric changes were also correlated with Marsh grade, self-reported adherence to a gluten-free diet, and changes in celiac serology.RESULTS:The gluten-free diet resulted in a progressive increase in villous area and a progressive decrease in crypt length. Morphometric improvement reached a plateau after 6-12 months with mean villous area attaining a value approximately half that of control subjects. Morphometric data were more sensitive than Marsh grade. Improvement in morphometric indices was significantly associated with the disappearance of anti-endomysial IgA antibody but not with dietary compliance.CONCLUSIONS:Morphometry is a sensitive way to document changes in duodenal biopsies in celiac disease. In adults treated with a gluten-free diet, it is uncommon for villous area to return to values observed in control subjects, but morphometric improvement is associated with the disappearance of anti-endomysial IgA antibody.


Related Articles

  • Is intestinal biopsy always needed for diagnosis of celiac disease? Scoglio, Riccardo; Di Pasquale, Giuseppe; Pagano, Giuseppe; Lucanto, Maria Cristina; Magazz├╣, Giuseppe; Sferlazzas, Concetta // American Journal of Gastroenterology;Jun2003, Vol. 98 Issue 6, p1325 

    : ObjectiveIntestinal biopsy is required for a diagnosis of celiac disease (CD). The aim of this study was to assess diagnostic accuracy of transglutaminase antibodies (TGA) in comparison and in association with that of antiemdomysial antibodies (AEA), calculating the post-test odds of having...

  • Vector manometry of the sphincter of Oddi: A new parameter of pancreatobiliary physiology. Okazaki, Kazuichi // Journal of Gastroenterology;1998, Vol. 33 Issue 6, p922 

    Editorial. Focuses on the vector manometric study of the sphincter of Oddi (SO) in the dog. Information on the SO and its influence in the excretion of the pancreatic juice or bile; Use of vector manometry in the estimation of motility; Relationship between SO motility and pancreatobiliary...

  • Prevalence of Undiagnosed Celiac Disease in the Parents of Preterm and/or Small for Gestational Age Infants. Salvatore, Silvia; Finazzi, Sergio; Radaelli, Giovanni; Lotzniker, Milvia; Zuccotti, Gian Vincenzo // American Journal of Gastroenterology;Jan2007, Vol. 102 Issue 1, p168 

    OBJECTIVES: The aim of this study was to estimate the prevalence of undiagnosed celiac disease (CD) in the parents of preterm and/or small for gestational age (SGA) infants. METHODS: A sample of 1,714 parents (868 women, 846 men) of 905 preterm (<37 wk of gestational age) and/or SGA (<10th...

  • Re: M Saginur, FAM AlRefaee, DW Spady, et al. Antitissue transglutaminase antibody determination versus upper endoscopic biopsy diagnosis of paediatric celiac disease. Paediatr Child Health 2013;18(5):246-250. Jong, Geert't // Paediatrics & Child Health (1205-7088);Aug/Sep2013, Vol. 18 Issue 7, p384 

    A letter to the editor is presented in response to the article "Antitissue transglutaminase antibody determination versus upper endoscopic biopsy diagnosis of paediatric celiac disease" in the previous issue.

  • Endoscopic removal of a duodenal foreign body. Thompson, M.H. // British Medical Journal;11/29/1975, Vol. 4 Issue 5995, p502 

    Reports the endoscopic removal of duodenal foreign body. Impact of ingesting foreign bodies to the cardio-esophageal junction; Use magnetic devices for surgery; Advantages of endoscopic removal.

  • Vector manometric study of the sphincter of Oddi in the dog: Functional and morphological correlation. Takeda, Torahiko; Tohma, Hiroki; Yoshida, Junichi; Naritomi, Gen; Konomi, Hiroyuki; Deng, Zhou-Lu; Kinukawa, Naoko; Tanaka, Masao // Journal of Gastroenterology;1998, Vol. 33 Issue 6, p860 

    Abstract: The relationship between sphincter of Oddi pressure and the morphological structure of the sphincter was studied in eight dogs prepared with a duodenal cannula. Sphincter of Oddi manometry was performed in awake animals in three directions, ventral, left dorsal, and right dorsal, using...

  • Imaging active lymphocytic infiltration in coeliac disease with iodine-123-interleukin-2 and the response to diet. Signore, Alberto; Chianelli, Marco; Annovazzi, Alessio; Rossi, Maurizio; Maiuri, Luigi; Greco, Marco; Ronga, Giuseppe; Britton, Keith E.; Picarelli, Antonio // European Journal of Nuclear Medicine;2000, Vol. 27 Issue 1, p18 

    Abstract. Coeliac disease is diagnosed by the presence of specific antibodies and a jejunal biopsy showing mucosal atrophy and mononuclear cell infiltration. Mucosal cell-mediated immune response is considered the central event in the pathogenesis of coeliac disease, and untreated coeliac...

  • Celiac disease.  // Canadian Family Physician;Jun2007, Vol. 53 Issue 6, p1061 

    The article presents a study which evaluates the performance of a clinical decision tool that detects celiac disease without the use of routine duodenal biopsy. It states that the tool can achieve a 100% sensitivity against celiac disease by using clinical information, serologic techniques, and...

  • Tissue Transglutaminase Levels Are Not Sufficient to Diagnose Celiac Disease in North American Practices Without Intestinal Biopsies. Elitsur, Yoram; Sigman, Terry; Watkins, Runa; Porto, Anthony; Leonard Puppa, Elaine; Foglio, Elsie; Preston, Deborah; Porto, Anthony F; Leonard Puppa, Elaine L; Foglio, Elsie J; Preston, Deborah L // Digestive Diseases & Sciences;Jan2017, Vol. 62 Issue 1, p175 

    Background: Celiac serology is crucial for the diagnosis of celiac disease in children. The American guideline for celiac disease in children suggested that positive serology should be followed by confirmatory intestinal histology. The relationship between high tissue...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics