Clinical phenotype and mortality in patients with idiopathic small bowel villous atrophy: a dual-centre international study

Schiepatti, Annalisa; Sanders, David S.; Aziz, Imran; Silvestri, Annalisa De; Goodwin, John; Key, Tim; Quaye, Lydia; Giuffrida, Paolo; Vanoli, Alessandro; Paulli, Marco; Cross, Simon S.; Vergani, Patricia; Betti, E.; Maiorano, Gregorio; Ellis, Richard J.; Snowden, John A.; Sabatino, Antonio Di; Corazza, Gino Roberto; Biagi, Federico

doi:10.1097/meg.0000000000001726

Cited by 16 publications

(18 citation statements)

References 52 publications

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“…These cases of idiopathic villous atrophy can be categorized further, based on clinical, histologic, and genetic characteristics, as due to transient conditions, such as infection; immune-driven conditions; or lymphoproliferative disorders. 32 A complete list of conditions other than seronegative CeD and the characteristic histologic features, associated tests, and treatments are described in Table 2.…”

Section: Evaluation Of Other Conditionsmentioning

confidence: 99%

AGA Clinical Practice Update on the Evaluation and Management of Seronegative Enteropathies: Expert Review

et al. 2021

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Section: Evaluation Of Other Conditionsmentioning

confidence: 99%

AGA Clinical Practice Update on the Evaluation and Management of Seronegative Enteropathies: Expert Review

et al. 2021

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“…Lastly, it should be remembered that forms of idiopathic villous atrophy (villous atrophy or sprue of unknown aetiology) may cause diagnostic challenges. Some of these patients have spontaneous histological recovery and are associated with excellent survival, whereas others show persistent villous atrophy, with or without associated lymphoproliferative disorders 51 .…”

Section: Differential Diagnosismentioning

confidence: 99%

Celiac disease: histology-differential diagnosis-complications. A practical approach

et al. 2020

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Summary Celiac disease is a multi-factorial chronic inflammatory intestinal disease, characterized by malabsorption resulting from mucosal injury after ingestion of wheat gluten or related rye and barley proteins. Inappropriate T-cell-mediated immune response against ingested gluten in genetically predisposed people, leads to characteristic histological lesions, as villous atrophy and intraepithelial lymphocytosis. Nevertheless, celiac disease is a comprehensive diagnosis with clinical, serological and genetic characteristics integrated with histological features. Biopsy of duodenal mucosa remains the gold standard in the diagnosis of celiac disease with the recognition of the spectrum of histological changes and classification of mucosa damage based on updated Corazza-Villanacci system. Appropriate differential diagnosis evaluation and clinical context also for the diagnosis of complications is, moreover, needed for correct histological features interpretation and clinical management.

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“…The third type of error is related to misdiagnosing RCD in patients with severe villous atrophy and malabsorption due to enteropathies unrelated to gluten ingestion such as autoimmune enteropathy, common variable immune-deficiency, olmesartan-associated enteropathy, and idiopathic villous atrophies [ 81 , 82 , 85 , 87 , 97 , 114 , 115 ].…”

Section: Non-responsive Coeliac Diseasementioning

confidence: 99%

Pitfalls in the Diagnosis of Coeliac Disease and Gluten-Related Disorders

et al. 2020

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The spectrum of gluten-related disorders (GRD) has emerged as a relevant phenomenon possibly impacting on health care procedures and costs worldwide. Current classification of GRD is mainly based on their pathophysiology, and the following categories can be distinguished: immune-mediated disorders that include coeliac disease (CD), dermatitis herpetiformis (DH), and gluten ataxia (GA); allergic reactions such as wheat allergy (WA); and non-coeliac gluten sensitivity (NCGS), a condition characterized by both gastrointestinal and extra-intestinal symptoms subjectively believed to be induced by the ingestion of gluten/wheat that has recently gained popularity. Although CD, DH, and WA are well-defined clinical entities, whose diagnosis is based on specific diagnostic criteria, a diagnosis of NCGS may on the contrary be considered only after the exclusion of other organic disorders. Neither allergic nor autoimmune mechanisms have been found to be involved in NCGS. Mistakes in the diagnosis of GRD are still a relevant clinical problem that may result in overtreatment of patients being unnecessary started on a gluten-free diet and waste of health-care resources. On the basis of our clinical experience and literature, we aim to identify the main pitfalls in the diagnosis of CD and its complications, DH, and WA. We provide a practical methodological approach to guide clinicians on how to recognize and avoid them.

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Clinical phenotype and mortality in patients with idiopathic small bowel villous atrophy: a dual-centre international study

Abstract: This is a repository copy of Clinical phenotype and mortality in patients with idiopathic small bowel villous atrophy: a dual-centre international study.

Cited by 16 publications

References 52 publications

AGA Clinical Practice Update on the Evaluation and Management of Seronegative Enteropathies: Expert Review

AGA Clinical Practice Update on the Evaluation and Management of Seronegative Enteropathies: Expert Review

Celiac disease: histology-differential diagnosis-complications. A practical approach

Pitfalls in the Diagnosis of Coeliac Disease and Gluten-Related Disorders

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