CELIAC DISEASE

HISTOPATHOLOGICAL EVALUATION OF ENDOSCOPIC DUODENAL (D2) BIOPSIES IN PATIENTS

Abstract

Objective: To find out the Modified Marsh type of celiac disease (CD)
patients on histopathological examination of duodenal (D2) biopsies and to correlate it with
tissue transglutaminase IgA levels. Study Design: Cross sectional study. Place of Study:
Histopathology laboratory (Department of Pathology), Isra University Hospital and Asian
Institute of Medical Sciences (AIMS), Hyderabad. Duration of Study: July 2013 to December
2013. Materials and Methods: 96 patients with a history of malabsorption or atypical symptoms
with clinical suspicion of CD were subjected to endoscopy. Endoscopic duodenal (D2) biopsies
were taken regardless of age and gender. D2 biopsies were processed for histopathological
examination under light microscopy. Results: Out of 96 patients, 45 (46.9%) patients had
moderate type of lamina propria inflammation along with highly significant p-value (0.0001).CD
type 3a was observed in 34 patients (35.4%). In this study the comparison of serological level of
tissue Transglutaminase IgA (tTGA) and histological severity revealed significant correlation. All
Modified Marsh types of CD with tTGA level seen in our study were highly significant (p-value
0.001). Conclusion: In this study strong correlation was observed between the serological
tTGA level and histological findings by Modified Marsh classification along with lamina propria
inflammation of duodenal mucosa in CD patients.