The differential diagnoses for severe enteropathy or severely damaged small intestinal mucosa

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dc.citation.issue2
dc.citation.volume16
dc.contributor.authorJian CLA
dc.contributor.authorHayman DTS
dc.contributor.authorLockett B
dc.contributor.authorRostami K
dc.date.accessioned2024-08-06T01:21:11Z
dc.date.available2024-08-06T01:21:11Z
dc.date.issued2023-04-21
dc.description.abstractAim: The aim of this study was to explore the aetiology of severe duodenal mucosal abnormality in consecutive patients who underwent gastroscopy and duodenal biopsy over the past 10 years. Background: A range of differential diagnoses have been reported for severe duodenal architectural distortion. Methods: Clinical and laboratory data of all the patients with severe duodenal architectural distortion diagnosed at MidCentral District Health Board (DHB), New Zealand were collected and statistically analysed. Ninety-five percent confidence intervals (CI) are shown. Results: Between September 2009 and April 2019, 229 patients were diagnosed with severe enteropathy. The median patient age was 41 years (range 6-83 years). Two hundred and twenty-four of these patients (97.8%, 95.0-99.3%) were diagnosed with coeliac disease (CeD), with one of these patients having gluten induced T-cell lymphoma. From the remaining five patients, one had a diagnosis of tropical sprue and four did not have a clear aetiology. There were 180 patients from 191 (94.2%, 89.9-97.1%) with at least one positive coeliac marker, all with a diagnosis of CeD. Eleven patients (5.8% of 191, 2.9-10.1%) had negative markers for both tissue transglutaminase IgA (tTG-IgA) and IgA-endomysial antibodies (EMA-IgA) with six having a diagnosis of seronegative CeD. Conclusion: Although the spectrum of histological changes in CeD may range from normal to a flat mucosa, severe duodenal architectural distortion seems to occur mainly in CeD. Idiopathic enteropathy was recorded as the second but by far less frequent presentation of severe enteropathy. This study highlights that infection and other aetiologies are rarely implicated in severe enteropathy, with one case (0.4%) of refractory CeD/T-cell lymphoma.
dc.description.confidentialfalse
dc.edition.edition2023
dc.format.pagination181-187
dc.identifier.citationJian CLA, Hayman DTS, Lockett B, Rostami K. (2023). The differential diagnoses for severe enteropathy or severely damaged small intestinal mucosa. Gastroenterology and Hepatology from Bed to Bench. 16. 2. (pp. 181-187).
dc.identifier.doi10.22037/ghfbb.v16i2.2717
dc.identifier.eissn2008-4234
dc.identifier.elements-typejournal-article
dc.identifier.issn2008-2258
dc.identifier.urihttps://mro.massey.ac.nz/handle/10179/71204
dc.languageEnglish
dc.publisherResearch Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences (RIGLD), affiliated to Shahid Beheshti University of Medical Sciences
dc.publisher.urihttps://journals.sbmu.ac.ir/ghfbb/index.php/ghfbb/article/view/2717
dc.relation.isPartOfGastroenterology and Hepatology from Bed to Bench
dc.rights(c) 2023 The Author/s
dc.rightsCC BY 4.0
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectCoeliac disease
dc.subjectDifferentials
dc.subjectSevere enteropathy
dc.subjectHistology
dc.titleThe differential diagnoses for severe enteropathy or severely damaged small intestinal mucosa
dc.typeJournal article
pubs.elements-id479910
pubs.organisational-groupOther
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