ENDOSCOPIC BIOPSIES , CELIAC DISEASE, SEROLOGICAL TEST

Zahraa A Hashim,Sarkis K Strak,Sura A Al-Namil,Wassan M Jazi

doi:10.33762/bsurg.2017.141318

Abstract

THE VALUE OF ENDOSCOPIC BIOPSIES FROM FIRST AND SECOND PARTS OF DUODENUM IN THE DIAGNOSIS OF CELIAC DISEASE IN CORRELATION WITH A SEROLOGICAL TEST Zahraa A Hashim*, Sura A AL-Namil@, Wassan M Jazi# & Sarkis K Strak$ *MB,ChB, Postgraduate board student. @MB,ChB, FIBMS, Consultant pathologist. #MB,ChB, FIBMS, Consultant pathologist, Al-Sadir Teaching Hospital. $MRCP, FRCPLond., FRCPI., Professor of Medicine, University of Basrah, IRAQ. Abstract Celiac disease is a chronic immune-mediated enteropathy of the small intestine caused by environmental exposure to gluten in genetically susceptible individuals. This study was conducted to evaluate and correlate the serological with histopathological findings of duodenal biopsies for the diagnosis of celiac disease. Sixty-eight patients, 40 (59%) females whose ages ranged from 13-75 year (mean age 36.4 years), and 28 (41%) males whose ages ranged from 13-65 year (mean age 37.8 years), with symptoms of chronic diarrhea, weight loss, bloating and unexplained iron deficiency anemia, were tested for anti-tissue transglutaminase IgA tTG, and correlated with histopathological findings of duodenal biopsies obtained from 1st and 2nd parts according to modified Marsh's classification. Histopathological findings from the 1st and 2nd duodenal parts were also compared with each other. The results of the 68 patients who were enrolled in the study showed that: 24(35.3%) patients tested positive for anti-tissue transglutaminase (titer >18U/ml), 37(55.8%) patients had positive histopathological changes (stage I–III). Twenty-three (33.8%) patients who had both positive anti tTG and histopathological changes were classified as a celiac disease. The sensitivity of 1st and 2nd parts of duodenal biopsies in detecting celiac disease were 83.7% and 100% respectively. In conclusion; the histopathological changes from the 1st and 2nd parts of duodenum in detecting celiac disease were equally representative especially in stage IIIa, b, and c.

Highlights

Celiac disease (CD) is a chronic immune-mediated enteropathy affects the small intestine caused by environmental exposure to gluten in genetically susceptible individuals, which demonstrates improvement with a withdrawal of gluten from the diet[1]
This study showed that the percentage of CD among studied patients was 23/68 (33.8%)
Patients with CD traditionally presented with malabsorption, such as diarrhea, weight loss and failure to thrive, but recently the non-classical CD, and asymptomatic CD have gained prominence[1]

Summary

Introduction

Celiac disease (CD) is a chronic immune-mediated enteropathy affects the small intestine caused by environmental exposure to gluten in genetically susceptible individuals, which demonstrates improvement with a withdrawal of gluten from the diet[1]. It occurs in about 1% of the general population worldwide, it still underdiagnosed[2]. The diagnosis of celiac disease is made by clinical presentation, typical antibody responses and duodenal biopsies appearance[8]. This study was conducted to evaluate and correlate the serological with histopathological findings of duodenal biopsies in the diagnosis of celiac disease

Patients and methods

Result

Findings

Discussion