The corelation between endoscopic and histological changes in the diagnosis of celiac disease to children

Abstract

Background. Depending on the clinical form, the intake of gluten and celiac disease stage of the histological changes are diverse and irregular, with a maximal manifestation in the duodenum and proximal jejunum from the undamaged mucous membrane to the entire vilar atrophy. Objectives. Assessing histological changes of the children with celiac disease. Material and methods. Based on a retrospective study conducted in the Gastroenterology Department of the Mother and Child’s Institute, during the years 2000 – 2006, based on Marsh’s endoscopic and histological criteria, 84 children with celiac disease were examined. Results. The endoscopic examination revealed a lightish mucous to 19 children (22.61%), thickened intestinal vilosities with a chorionic height decreases to 21 children (25%), moderate villous atrophy 13 children (15.47%), the slightly disorganized vascular network is damaged to 12 children (14.28%) and no endoscopic changes to 24 children (28.57%). Histological changes Marsh 0 (normal mucous or preinfusible phase) to 29 children (34.52%), Marsh I (intraepithelial lymphocytes infiltrated in vilosital epithelium) - 31 cases (36.9%), Marsh II (crypts hyperplasia) - 11 cases (13.09%), Marsh III (moderate vilozital atrophy) - 9 children (10.71%), Marsh IV (total vilosital atrophy) – any subject. Conclusion. For definitive diagnosis of celiac disease, the histological examination could be considered the gold standard because in 48 of subjects (57.14%) the endoscopic examination showed a intact mucous membrane.