Small bowel biopsy for malabsorption: comparison of the diagnostic adequacy of endoscopic forceps and capsule biopsy specimens.

Mee, Anthony S.; Burke, Mary; Vallon, A G; Newman, Joseph V.; Cotton, P B

doi:10.1136/bmj.291.6498.769

Cited by 103 publications

(49 citation statements)

References 16 publications

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“…31,32 Furthermore, he found that the remaining 6% of biopsies, although they showed different grades, would not have significantly affected clinical management. Lesions of higher severity could be found limited to either the duodenum or the jejunum.…”

Section: Location Of Intestinal Biopsymentioning

confidence: 99%

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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Section: Location Of Intestinal Biopsymentioning

confidence: 99%

The Clinical Significance of Duodenal Lymphocytosis With Normal Villus Architecture

Hammer

Greenson

2013

Archives of Pathology &Amp; Laboratory Medicine

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“…110,111 Thus, obtaining only two biopsy specimens will lead to a confirmed diagnosis in only 90%, whereas four specimens will lead to 100% confidence in diagnosis. 111 However, because of the patchy nature of villous atrophy, a five-biopsy regimen including one from the duodenal bulb, two from the first part and two from the second part of the duodenum, is required for detection of the most severe lesion.…”

mentioning

confidence: 99%

Systematic review: the evidence base for long‐term management of coeliac disease

Haines

Anderson

Gibson

2008

Aliment Pharmacol Ther

182

144

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“…10,20 A recent study demonstrated that four biopsies may be sufficient for CD diagnosis in 100% of cases. 21,22 Mucous alterations have an irregular pattern, well demonstrated in magnification, 23,24 mainly associated with chromoendoscopy; 24 Brunner glands and peptic alterations may hinder histological exam, if biopsies are too proximal.…”

Section: Duodenal Biopsymentioning

confidence: 99%

“…Biopsies may have an adequate size, be well oriented with villi turned upside, on filter paper, enabling for crossing and non-tangent sections, for tangential cuts may lead to misinterpretations. The type of 21,32 Mucosa inflammation and architecture alterations may be concealed using corticoids and immunosuppressive agents.…”

Section: Duodenal Biopsymentioning

confidence: 99%

Diagnóstico de doença celíaca em adultos

Silva

Furlanetto

2010

Rev. Assoc. Med. Bras.

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Celiac disease (CD) is found in genetically predisposed individuals, and characterized by intolerance to gluten ingestion, contained in cereals such as barley, rye, wheat and malt. Clinical manifestations vary from asymptomatic patients to severe forms of malabsorption syndromes, which may involve multiple systems and increase the risk of some neoplasias. Diagnosis of CD often requires a high degree of suspicion. There is not a single test for the diagnosis, which is reached after a combination of clinical and laboratory data. The first step may be a serum test, such as the antibodies anti-tissue transglutaminase, or antiendomisio. If serum result is positive, duodenal biopsy is necessary for diagnostic confirmation. IgA deficiency, which occurs in 3% of patients with DC, may lead to false-negatives because serology is based on IgA antibodies. Another cause of false-negative tests is diet restriction of gluten; therefore diagnostic investigation must be carried out during a diet containing gluten. The screening for CD in asymptomatic individuals is not indicated.

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Small bowel biopsy for malabsorption: comparison of the diagnostic adequacy of endoscopic forceps and capsule biopsy specimens.

Cited by 103 publications

References 16 publications

The Clinical Significance of Duodenal Lymphocytosis With Normal Villus Architecture

The Clinical Significance of Duodenal Lymphocytosis With Normal Villus Architecture

Systematic review: the evidence base for long‐term management of coeliac disease

Diagnóstico de doença celíaca em adultos

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