Jejunal Biopsy in Patients with Malabsorptive Disease

Rh, Girdwood; Aw, Williams; Jp, McManus; Aw, Dellipiani; Iw, Delamore; Pw, Kershaw

doi:10.1177/003693306601101001

Cited by 16 publications

(7 citation statements)

References 22 publications

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“…Again these differences are not statistically significant. logical features of subtotal villous atrophy in one of the parents in our series of 17 families is considered to be definitely pathological, for a change of this sort was not found in control series studied in Newcastle upon Tyne and in other geographical areas (Baker, Ignatius, Mathan, Vaish, and Chacko, 1962;Scott, Williams, and Clark, 1964;Banwell, Hutt, and Tunnicliffe, 1964;Salem and Truelove, 1965;England and O'Brien, 1966;Girdwood, Williams, McManus, Dellipiani, Delamore, and Kershaw, 1966;Stewart et al, 1967). Although we regarded this mother as not suffering from clinical coeliac disease it is probable that the mucosal abnormality was gluteninduced (Hindle and Creamer, 1965).…”

Section: Clinical Findingsmentioning

confidence: 56%

Incidence of small-intestinal mucosal abnormalities and of clinical coeliac disease in the relatives of children with coeliac disease

Robinson¹,

Watson²,

Wyatt³

et al. 1971

Gut

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SUMMARY Evidence is presented of a higher than normal incidence both of clinical coeliac disease and of small-intestinal mucosal abnormalities in relatives of children with coeliac disease. In such relatives the incidence of mucosal abnormality may differ from the incidence of clinical coeliac disease. The data show an absence of any simple Mendelian pattern of inheritance: in place of the hypothesis that inheritance is through a dominant gene of reduced penetrance, it is argued that the pathogenesis of coeliac disease is multifactorial, the genetic basis of susceptibility being polygenic and interacting with environmental factors. On this hypothesis the relative contributions of inheritance and environment to liability to the clinical condition are estimated, the genetic component being 45% ± 9. Environmental factors appear more important in the development of mucosal abnormality.

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Section: Clinical Findingsmentioning

confidence: 56%

Incidence of small-intestinal mucosal abnormalities and of clinical coeliac disease in the relatives of children with coeliac disease

Robinson¹,

Watson²,

Wyatt³

et al. 1971

Gut

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“…Forty-eight patients were studied, including a group of controls and patients with renal failure, primary malabsorptive disease, osteomalacia and some who had undergone gastric surgery. The diagnosis of primary malabsorptive disease was based on methods described elsewhere (Girdwood et al, 1966).…”

Section: E T H O D Smentioning

confidence: 99%

Plasma Concentrations of Radiocalcium after Oral Administration, and Their Relationship to Absorption

1970

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S U M M A R Y1. Different radioisotopes of calcium were administered orally and intravenously to a series of patients, some normal and others with diseases that might affect calcium absorption or metabolism. Concentrations of the two isotopes in plasma were determined at intervals. A mathematical procedure was developed for deriving from these measurements the total absorption of the oral dose and also the absorption/time relationship.2. The correlation between absorption and plasma concentration of the oral dose at various times after administration was studied and found to be very good, the 2 hr plasma level giving the best correlation, particularly when account was taken of the patient's weight.3. The effect of variations in the disappearance curve of the injected isotope upon the shape of the plasma appearance curve of the oral isotope was examined. It is concluded that for the majority of cases, when absorption is not greatly delayed, and the exchange processes determining the shape of the disappearance curve are not markedly abnormal, 2 hr plasma concentration gives a good indication of absorption. When abnormalities in these processes are present, only the double isotope method gives accurate results.4. The results were applied to examine the validity of other published methods of analysis. It was found that plasma concentrations of orally administered radiocalcium alone can give useful information about absorption, but not about plasma clearance.Measurement of plasma levels of radioactive calcium after oral administration was introduced by Bhandarkar et al. (1961) to provide an estimate of calcium absorption. After considering serial measurements they decided that the 2 hr level gave a useful index of absorption and compared this with absorption as measured by metabolic balance studies. Other authors have used different times, and more recently the whole of the early part of the plasma concentration

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“…With the advent of suitable instruments for taking multiple biopsies (Brandborg et al, 1959;Baker and Hughes, 1960;Flick et al, 1961), it has been possible to assess patchiness, but apparently no formal study of this has been undertaken. There are divergent opinions about patchiness, some leading workers in North America denying its existence in untreated CD (Jeffries et al, 1968;Brow et al, 1971;Gebhard et al, 1974), whereas many isolated cases of this have been reported from the United Kingdom (Holmes et al, 1961;Hourihane, 1963;Scott et al, 1964;Spiro et al, 1964;Roy-Choudhury et al, 1966;Girdwood et al, 1966;Thompson, 1974). In DH there is less disagreement and some have taken the existence of patchiness as evidence for a different mucosal lesion in that condition (Brow et al, 1971;Gebhard et al, 1974).…”

mentioning

confidence: 99%

Patchiness and duodenal-jejunal variation of the mucosal abnormality in coeliac disease and dermatitis herpetiformis.

Scott¹,

Losowsky²

1976

Gut

167

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SUMMARY The incidence and degree of patchiness of mucosal abnormality in both coeliac disease (CD) and dermatitis herpetiformis (DH) is documented. As judged by both stereomicroscopy and subjective histology, patchiness occurred frequently in both CD and DH patients. In most cases the difference of abnormality was of only one grade, but in approximately 25% as assessed by stereomicroscopy and 10% as assessed by histology the difference was of two or more grades. In control subjects with normal small bowel mucosa the variation of the mucosal appearance between the duodenum and proximal jejunum was studied. Contrary to popular belief, no significant difference of villous and crypt measurements or of apparent villous 'bridging' and 'branching' betWeen these two sites was found, if only well-orientated sections were studied. The stereomicroscopic appearances were also similar at these two sites, although villi tended to be broader in the duodenal biopsies. The duodenal-jejunal variation was also studied in CD and DH patients and, although by both stereomicroscopy and subjective histology the appearances were similar in most patients, in approximately 33% the duodenal abnormality was the more severe and, surprisingly,

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Jejunal Biopsy in Patients with Malabsorptive Disease

Cited by 16 publications

References 22 publications

Incidence of small-intestinal mucosal abnormalities and of clinical coeliac disease in the relatives of children with coeliac disease

Incidence of small-intestinal mucosal abnormalities and of clinical coeliac disease in the relatives of children with coeliac disease

Plasma Concentrations of Radiocalcium after Oral Administration, and Their Relationship to Absorption

Patchiness and duodenal-jejunal variation of the mucosal abnormality in coeliac disease and dermatitis herpetiformis.

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