[Histopathological diagnosis of celiac disease in children and adults: 3 years' experience]
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Published on: April 26, 2019
V Villanacci1, G Cornolti, F Lanzarotto
12o Servizio di Anatomia ed Istologia Patologica, Spedali Civili, Piazzale Spedali Civili 1, I-25100 Brescia, Italia. villan@iol.it
Insights
This study highlights key factors for accurate coeliac disease diagnosis, including proper biopsy handling and updated classification systems. It also notes the rising incidence of coeliac disease in adults.
Area of Science:
- Gastroenterology
- Histopathology
- Pediatric Medicine
Context:
- Routine histopathologic diagnosis of coeliac disease.
- Analysis of over 300 pediatric and adult cases over 3 years.
- Evaluation of diagnostic challenges and findings.
Purpose:
- To describe personal experience with coeliac disease histopathology.
- To highlight critical factors for accurate diagnosis.
- To report on disease incidence across age groups.
Summary:
- Biopsy orientation on Millipore filters is crucial for accurate coeliac disease diagnosis.
- Inconsistent submission of clinical and laboratory data impacts diagnostic workflow.
- The modified Marsh classification by Oberhuber correlates well with disease status before and after dietary intervention.
- Coeliac disease incidence is increasing in adults, though children under 11 were most affected in this cohort (25%).
Impact:
- Improved diagnostic accuracy through standardized biopsy handling.
- Enhanced collaboration between clinicians and pathologists.
- Better application of classification systems for disease management.
- Increased awareness of adult coeliac disease presentation and diagnosis.
Abstract:
We describe our personal experience with the routine histopathologic diagnosis of coeliac disease in pediatric and adult ages, over a period of 3 years. The most important indications based on the examination of over 300 cases include: (a) the importance of a correct orientation of biopsies on Millipore filters; (b) the not regular sending of clinical and laboratory results; (c) the better correspondence of modified Marsh classification by Oberhuber to the histologic characteristics of the disease before and after dieting; and (d) the increasing incidence of coeliac disease in adult age, even though in this case series the age-class most affected was that under 11 years (75 cases, 25%).
