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

Scott, B B; Losowsky, M. S.

doi:10.1136/gut.17.12.984

Cited by 167 publications

(78 citation statements)

References 24 publications

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“…The main villous height in their sixteen geriatric pa tients was 371 pm, significantly lower than the mean (471 pm) of previously reported villous height values for healthy adult con trols. However, more recent studies [18,20,22] reported mean villous height values in healthy adult subjects very close to those of the geratric patients studied by Webster and Leeming [251.…”

Section: Discussionmentioning

confidence: 99%

Ageing and Small-Bowel Mucosa: A Morphometric Study

Frazzoni¹,

Gatto²,

Gasbarrini³

1986

Gerontology

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A direct effect of ageing in reducing mucosal surface area of the small intestine is still disputed. The aim of this study was to morphometrically evaluate a panel of jejunal biopsy specimens obtained from 16 elderly patients and 22 younger controls, all complaining of abdominal symptoms but without evidence of malabsorption and/or malnutrition in either group. Quantitative histology was performed by calculating the surface area to volume ratio of jejunal mucosa and the mean enterocyte height. The mean of surface to volume ratios in geriatric patients (97.6 ± 18), although slightly reduced, did not significantly differ from that of younger controls (107.6 ± 26) and no significant correlation was found between surface to volume ratio and age in years. The mean enterocyte height in the elderly group (30.1 ± 1.2 μm) did not significantly differ from that of younger controls (31.3 ± 2.3 μm). In conclusion, the frequent finding of malnutrition due to malabsorption in the elderly should not be attributed to a reduction of jejunal surface area as a mere consequence of age.

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Section: Discussionmentioning

confidence: 99%

Ageing and Small-Bowel Mucosa: A Morphometric Study

Frazzoni¹,

Gatto²,

Gasbarrini³

1986

Gerontology

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“…Some small differences between duodenal and jejunal mucosa have been noted on stereomicroscopy. Scott et al 29 found a tendency for the villi to be broader in the duodenum and a tendency for the crypts to be shorter in the jejunum. Some studies have reported on the patchiness of celiac disease, which seems to be true regardless of the site of biopsy.…”

Section: Location Of Intestinal Biopsymentioning

confidence: 98%

The Clinical Significance of Duodenal Lymphocytosis With Normal Villus Architecture

Hammer

Greenson

2013

Archives of Pathology &Amp; Laboratory Medicine

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Context.-The finding of increased intraepithelial lymphocytes with normal villous architecture (Marsh I lesion) is seen in up to 3% of duodenal biopsies. The differential diagnosis includes a wide range of possibilities, including celiac disease, bacterial overgrowth, nonsteroidal antiinflammatory drug damage, reaction to Helicobacter pylori infection, tropical sprue, and chronic inflammatory bowel disease.Objectives.-To highlight the histologic features of the Marsh I lesion, review the diseases and conditions associated with that finding, and to provide pathologists with a rationale and a template for how to identify and report such cases.Data Sources.-A review of the literature regarding the histologic features and clinical associations of Marsh I lesions.Conclusions.-Marsh I lesions are a nonspecific finding associated with a number of disease conditions. Historically, between 9% and 40% of cases have been shown to represent celiac disease. Current data do not suggest histologic features to differentiate between diseases associated with this histologic change.

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“…Specimens were fixed both in alcoholic solution and in formalin and successively stained with hematoxylin and eosin for routine examination; the histology was described by an examiner unaware of the laboratory test results. Mucosal condition was evaluated according to Scott and Losowski [ 13] as villous height to total mucosal thickness ratio. Total mucosal thickness (distance from the tip of the villus or the flat surface to the muscularis muco sae) and crypt depth (the distance from the muscularis mucosae to the dilation of the crypt at the base of the villus) were measured in five well-oriented villi.…”

Section: Methodsmentioning

confidence: 99%

Pancreatitis-Associated Protein in Patients with Celiac Disease: Serum Levels and Immunocytochemical Localization in Small Intestine

Carroccio

Iovanna²,

Iacono³

et al. 1997

Digestion

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Since PAP is a stress protein expressed in human pancreas during pancreatitis but also constitutively synthesized in the small intestine, we looked whether its expression would be altered in patients with celiac disease. Serum PAP concentrations were determined consecutively in 54 patients with celiac disease on a free diet (group A), in 47 patients with celiac disease on a gluten-free diet (group B), in 22 patients with other intestinal pathologies but with normal intestinal mucosa (group C), in 14 patients with retarded growth, no gastrointestinal disease and normal intestinal mucosa (group D), and in 17 controls (group E). Serum PAP levels (ng/ml) were significantly higher in group A (127.3 ± 56.8) than in the other groups (B: 47.2 ± 20.5; C: 51.5 ± 32.2; D: 47 ± 22.8; E: 27.6 ± 9.0), which were not different from each other. In group A, a positive correlation was observed between serum PAP values and antigluten antibody levels (vs. AGA IgG r – 0.58, p < 0.001; vs. AGA IgA r = 0.66, p < 0.001). Furthermore, 12 patients from group A were evaluated after 10-12 months of gluten-free diet and in all of them PAP serum concentration had decreased (mean ± SE before the diet 122.5 ± 36.4, after the diet 48.7 ± 13.7, p < 0.0001). In addition, we performed an immunocytochemical study to localize PAP in the intestinal mucosa of patients from all groups except E. PAP was localized to the Paneth cells and to some globet cells, in patients with mucosal atrophy as well as in those with normal mucosa with no obvious quantitative difference. We concluded that in patients with celiac disease the active phase of the disease was accompanied by an increased serum concentration of PAP. Further studies are necessary to understand the mechanism leading to PAP elevation in the serum of patients with celiac disease.

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

Cited by 167 publications

References 24 publications

Ageing and Small-Bowel Mucosa: A Morphometric Study

Ageing and Small-Bowel Mucosa: A Morphometric Study

The Clinical Significance of Duodenal Lymphocytosis With Normal Villus Architecture

Pancreatitis-Associated Protein in Patients with Celiac Disease: Serum Levels and Immunocytochemical Localization in Small Intestine

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