What question did this study set out to answer?

This study aims to document the clinical and pathological variations in celiac disease, highlighting underreported microscopic features.

July 9, 2026Open Access

Clinicopathological Spectrum of Duodenal Biopsies in Celiac Disease

Key Points

This study aims to document the clinical and pathological variations in celiac disease, highlighting underreported microscopic features.
Retrospective cohort study of 27 celiac disease cases.
Assessment of demographic, clinical, and laboratory findings including histopathology of duodenal biopsies.
Descriptive statistics and chi-square tests to evaluate associations between variables.
22.2% of cases showed atypical manifestations like refractory anemia and hypoproteinemia.
96.3% had elevated serum IgA anti-tTG levels, with 62.5% displaying endoscopic abnormalities.
85.2% exhibited villous atrophy, correlated with increased intraepithelial lymphocytes in 74%.

Abstract

Background: This study was conducted to report all the clinico-pathological variations associated with celiac disease including many underreported microscopic features which can cause diagnostic confusions.Methods: This retrospective cohort study included 27 cases of celiac disease. Laboratory findings, demographic and clinical features were noted. Histopathology slides of duodenal biopsy specimens were examined microscopically. Descriptive statistics were used to summarize the data. Chi-square test was used to study the association between the variables. Result: The study included 15 males and 12 females (M:F = 1.2:1), with a mean age of 26.4 years (range: 2–54 years). Atypical manifestations, such as refractory anemia, short stature and hypoproteinemia were observed in 22.2% cases. Associated immunological disorders were observed in 40.7% of cases; most commonly type 1 diabetes mellitus (14.8%). Elevated serum IgA anti-tTG levels were noted in 96.3% of patients, excluding one with severe IgA deficiency. Endoscopic abnormalities were identified in 62.5% of cases. Histologically, 85.2% showed villous atrophy, with 70.4% in Marsh stage 3. Increased intraepithelial lymphocytes were noted in 74% of cases. Lamina propria showed varying degrees of lymphoplasmacytic, eosinophilic, and neutrophilic infiltration, showing correlation with the severity of villous atrophy (p value <0.05). Nine cases (33.3%) demonstrated surface epithelial changes. One case showed surface neutrophilic infiltrate.Conclusion: Duodenal biopsies are recommended in suspected, serology-positive cases even without endoscopic changes. Celiac disease histology ranges from normal villi to variable villous blunting and increased intraepithelial lymphocytes. Additional epithelial or inflammatory changes may cause diagnostic pitfalls.

KI fragen

Bookmark

View Full Paper