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Villous atrophy and negative celiac serology: a diagnostic and therapeutic dilemma.
Table 15) Even in those cases where malabsorption was present, jejunal biopsy showed abnormality in two cases, where one had parial villous atrophy and one had chronic nonspecific inflammatory changes.
The first study tested patients newly diagnosed with celiac disease before and alter starting a gluten-free diet, patients with persistent small bowel villous atrophy despite a strict gluten-free diet, and patients reporting abdominal symptoms after eating cereal.
Celiac Disease (CD) is an immune response to inge- sted wheat gluten and related proteins of rye and barley that leads to inflammation, villous atrophy and intestinal crypt hyperplasia.
Our results demonstrate that metabolic alterations may precede the development of small intestinal villous atrophy and provide a further rationale for early institution of gluten-free diet in patients with potential celiac disease, as recently suggested by prospective clinical studies," concluded the scientists.
5%) of the 17 anti-tTG-seronegative patients revealed partial villous atrophy (Marsh type IIIa or IIIb) or non-pathologic histology (type 0), compared with 54.
Histologically, the enteropathy involves inflammatory infiltrates of lymphocytes and damage to the GI epithelial layer including villous atrophy and blunting, along with crypt hyperplasia [3,5,14].
After a few tests, she was told that she has gastric atrophy and villous atrophy of the small bowel.
Most celiac disease patients (90%) will have a March III lesion on biopsy, which includes partial, subtotal, and total villous atrophy.
These researchers suggest that sensitivity to gluten might create symptoms in the absence of villous atrophy.