a 62-year-old woman complaining of severe malabsorption was diagnosed with celiac disease based on the findings of flat, small intestinal mucosa and hla-dq2 positivity, although celiac serology was negative. this diagnosis was questioned due to the lack of clinical and histological improvement after a long period of strict gluten-free diet. the detection of enterocyte autoantibodies guided to t...

Celiac disease is the most important cause of intestinal villous atrophy. Seronegative intestinal villous atrophy, including those that are nonresponsive to a gluten-free diet, is a diagnostic challenge. In these cases, before establishing the diagnosis of seronegative celiac disease, alternative etiologies of atrophic enteropathy should be considered. Recently, a new clinical entity responsibl...

BACKGROUND Endoscopy and biopsy are used to diagnose coeliac disease. There are, however, observer-dependent interpretations of the degree of villous atrophy in biopsies. A pilot study using quantitative image-processing procedures was performed to quantify the degree of villous atrophy in patients with coeliac disease. METHOD The degree of villous atrophy in duodenal biopsy images was quanti...

BACKGROUND Lymphocytic gastritis (LG) is an uncommon entity with varying symptoms and endoscopic appearances. This condition, as well as two forms of H. pylori-negative gastritis [chronic active gastritis (CAG) and chronic inactive gastritis (CIG)], appears to be more common in patients with coeliac disease (CD) based on single-centred studies. AIM To compare the prevalence of LG, CAG and CIG...

BACKGROUND Magnification endoscopy (ME), with 115-fold magnification, allows visualization of duodenal villi. We assessed the efficacy of ME for evaluation of villous atrophy. METHODS ME and duodenal biopsy were done in 16 patients with suspected celiac disease and 16 control subjects undergoing endoscopy for reflux symptoms. The pathologist was unaware of the ME findings. RESULTS Sensitivi...

AIM To quantify the presence of villous atrophy in endoscopic images for improved automation. METHODS There are two main categories of quantitative descriptors helpful to detect villous atrophy: (1) Statistical and (2) Syntactic. Statistical descriptors measure the small intestinal substrate in endoscope-acquired images based on mathematical methods. Texture is the most commonly used statisti...

BACKGROUND & AIMS Studies have associated undiagnosed celiac disease with adverse outcomes of pregnancy. We investigated the association between persistent villous atrophy and outcomes of pregnancy in women with celiac disease. METHODS We collected data on 337 women with celiac disease who gave birth (to 460 infants) within 5 years of a follow-up biopsy, from 28 pathology departments in Swede...

BACKGROUND The 'immersion' technique during upper endoscopy allows the visualization of duodenal villi and the detection of total villous atrophy. AIM To evaluate the accuracy of the immersion technique in detecting total villous atrophy in suspected coeliac patients. The accuracy in diagnosing coeliac disease and the potential cost-sparing of a biopsy-avoiding approach, based on selection of...

Refractory celiac disease (RCD) is when malabsorption symptoms and villous atrophy persist despite strict adherence to a gluten free diet (GFD) for more than 12 months and other causes of villous atrophy have been ruled out.  RCD is considered a rare disease and almost exclusively occurs in adults. Persistent diarrhea, abdominal pain, weight loss are the most common symptoms in RCD. Also, anemi...