Histological evaluation of duodenal biopsies from coeliac patients: the need for different grading criteria during follow-up

BMC Gastroenterology

Stefano Ferrero⁴  Leda Roncoroni²  Letterio Runza¹  Dario Conte³  Silvano Bosari³  Maria Teresa Bardella²  Carolina Tomba³  Enea Zini¹  Luca Elli² 

[1]Pathology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via F. Sforza 28, Milan, 20100, Italy

[2]Center for the Prevention and Diagnosis of Coeliac Disease, Gastroenterology and Endoscopy Unit - Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via F. Sforza 28, Milan, 20100, Italy

[3]Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Via Festa del Perdono 7, Milan, 20100, Italy

[4]Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Via Festa del Perdono 7, Milan, 20100, Italy

关键词: Malabsorption;    Histopathology;    Small Intestine;    Coeliac Disease;   

Others  :  1234377
DOI  :  10.1186/s12876-015-0361-8

 received in 2014-11-23, accepted in 2015-10-01,  发布年份 2015

【 摘 要 】

Background

Coeliac disease is characterised by villous atrophy, which usually normalises after gluten withdrawal. Sometimes the revaluation of duodenal histology is required during follow-up, even if the methodology for comparing duodenal histology before and after introducing a gluten-free diet is not yet established. Our aim was to evaluate a novel criterion to compare duodenal histology in coeliac disease before and after gluten withdrawal.

Methods

Duodenal biopsies from coeliac patients were retrospectively reviewed to compare duodenal histology at diagnosis and after at least one year on a gluten-free diet. Two different methods were used: the first was represented by the classical Marsh-Oberhuber score, the second compared the areas covered by each Marsh-Oberhuber grade and expressed as percentages, the final grade being calculated from the analysis of ten power fields per duodenal biopsy.

Results

Sixty-nine patients (17 males 52 females, age at diagnosis 36 ± 15 years) who underwent duodenal biopsies, were considered. According to the classical Marsh-Oberhuber scale, 32 patients did not present atrophy during follow-up while 37 showed duodenal atrophy, among whom 26 improved the grade of severity and 11 retained the same one. Of these latter, according to the second method, eight patients were considered improved, two showed a worsened duodenal damage and only one remained unchanged; the evaluation changed in 91 % of cases.

Conclusions

The proposed semi-quantitative approach (i.e. the second method) for the evaluation of histology at follow-up provides additional information about the progression/regression of the mucosal damage.

【 授权许可】

   
2015 Elli et al.

【 图 表 】

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