Duodenal biopsy in malabsorption-A clinicopathological study

Abstract

Aims: To study the morphologic spectrum of duodenal biopsy specimens in malabsorption, to correlate the histology with clinical, endoscopic and serological investigations and to assess various aetiologies of malabsorption. Material and Methods: Duodenal biopsies of 50 patients presenting with symptoms of malabsorption were analysed over a period of one year. The clinical details of patients, including their routine blood investigations, serology for Serum tissue transglutaminase (IgA t TG) and Upper gastrointestinal (UGI) endoscopic findings were noted. The villous architecture, villous to crypt ratio (V: C ratio), crypt examination and Intraepithelial lymphocytes were counted. Other findings like presence of parasites, dilated lymphatics, granulomas were also noted down. Results and conclusions: The mean age of presentation was 32.5 years, with a mild female preponderance. Endoscopic mucosal abnormalities were found in 42% of cases and microscopic villous atrophy in 46% of cases. Increase in IELs was found in 48% of cases. Celiac disease was the leading cause (28%) of malabsorption whereas Tropical sprue accounted for only 4% of cases. Not a single case of tuberculosis was encountered. Keyword: Duodenal biopsu, Malabsorption, Celiac diseases, Intraepithelial lymphocytes, Rillous architecture