Critical assessment of small bowel biopsy in children.

Glasgow, J. F. T.; Corkey, C. W. B.; Molla, A

doi:10.1136/adc.54.8.604

Archives of Disease in Childhood

1979

DOI: 10.1136/adc.54.8.604

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Critical assessment of small bowel biopsy in children.

J. F. T. Glasgow¹,

C. W. B. Corkey²,

A Molla³

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1981

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Cited by 11 publications

(1 citation statement)

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“…Initial technique s using a grid to measure villous height , width , and muco sal depth (11) failed to give reproducible results (12). More elaborate measurements of surface to volume ratios and mucosal volume (13) failed to differentiate biopsies showing partial villous atrophy from either normal or flat mucosae (14). A potentially more useful quantitation has come from counts of intraepithelial lymphocytes (IE Ls), with both lymphocyte s per 100 epithelial cells (15) and lymphocyte s per unit length of rnus-cularis muco sa (16) being increas ed in act ive coeliac disease .…”

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confidence: 99%

Predictive Value of Intraepithelial Lymphocyte Counts in Childhood Coeliac Disease

Taylor

1988

J. pediatr. gastroenterol. nutr.

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Summary:To evaluate the use of intraepithelial lymphocyte (IEL) counts in identifying coeliac disease in childhood the jejunal histology from 116 children initially diagnosed as coeliac was reviewed. The diagnosis had been based on a characteristic mucosal abnormality and an apparent response to gluten exclusion. Lymphocyte counts were performed by one observer on the presenting biopsy and tissue samples obtained before and after a supervised gluten challenge. Results were expressed as IELs/100 enterocytes. On challenge 49% of patients failed to show histological deterioration with only one late relapse on 2 year follow‐up. Reappraisal of these cases suggested alternate diagnoses, of which cow's milk protein intolerance (CMPI) (16%) and postenteritis malabsorption (20%) were the most common. In confirmed coeliacs IEL counts were high at diagnosis (67 ± 16) (mean ± SD), fell on diet (28 ±13), and rose on challenge (64 ± 20). These changes were significant (p < 0.01 using paired t test). Raised IEL counts at diagnosis were also found in patients with CMPI and giardiasis but a significant fall on diet only occurred in CMPI patients (p < 0.05). Only patients showing mucosal relapse, i.e., confirmed coeliacs, showed a significant increase in lELs postgluten challenge compared with counts on a gluten‐free diet. Although an increase in lELs showed good correlation with mucosal relapse on challenge, a high count at diagnosis was of insufficient specificity to obviate the need for gluten challenge.

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confidence: 99%

Predictive Value of Intraepithelial Lymphocyte Counts in Childhood Coeliac Disease

Taylor

1988

J. pediatr. gastroenterol. nutr.

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Observer Variation in Assessment of Jejunal Biopsy Specimens

Corazza¹,

Bonvicini²,

Frazzoni³

et al. 1982

Gastroenterology

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A simple method of duodenal juice collection in association with small bowel biopsy in children

Ford

1981

J Paediatrics Child Health

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Critical assessment of small bowel biopsy in children.

Cited by 11 publications

References 14 publications

Predictive Value of Intraepithelial Lymphocyte Counts in Childhood Coeliac Disease

Predictive Value of Intraepithelial Lymphocyte Counts in Childhood Coeliac Disease

Observer Variation in Assessment of Jejunal Biopsy Specimens

A simple method of duodenal juice collection in association with small bowel biopsy in children

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