ArticleJournal of the Canadian Association of Gastroenterology2020
Duodenal Bulb Histology in Paediatric Celiac Disease: A Case-Control Study.
Article in Journal of the Canadian Association of Gastroenterology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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5 citing papers in PubMed, 8 citations in OpenAlex.
- The frequency and characteristics of ultra-short celiac disease in children: A single-center experience.European journal of pediatrics · 2026Article
- Adherence to guidelines, pitfalls, and emerging technologies in endoscopic practice for celiac disease: a nationwide SIGENP survey.European journal of pediatrics · 2026Article
- The correct methodological approach to the diagnosis of celiac disease: the point of view of the pathologist.Gastroenterology and hepatology from bed to bench · 2023Review
- Histopathology of intestinal villi in neonatal and paediatric age: main features with clinical correlation - Part II.Pathologica · 2022Review
- Multiple Small Bowel Intussusceptions Detected by Diagnostic Laparoscopy in an Adult Patient with Previously Undiagnosed Coeliac Disease.European journal of case reports in internal medicine · 2022Article
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundControversy exists about optimal methods for duodenal biopsy in diagnosis of celiac disease (CD), in terms of both number of samples and anatomic location. The reliability of duodenal bulb biopsy has been questioned given that normal bulb architecture may mimic disease. However, multiple studies have reported patients with CD have histopathological lesions limited to proximal changes in the duodenal bulb alone.
methodsWe retrospectively compared duodenal and duodenal bulb histology in a population of paediatric patients with CD and compared with a population of nonceliac controls at Stollery Children's Hospital, 2010 to 2012.
resultsFifty-seven paediatric patients diagnosed with CD and 16 nonceliac controls were included in the study. Fifty-three celiac patients (93.0%) had histopathology consistent with CD (modified Marsh score of 3A, 3B or 3C) in the duodenal bulb. The modified Marsh classification differed significantly between duodenum and duodenal bulb in nine celiac patients (15.8%). Of these, five (8.8%) had Marsh 3 in the bulb and Marsh 0 in the distal duodenum. Among controls, no patients had villous atrophy in either the distal duodenum or duodenal bulb, and all patients had a modified Marsh score of 0 at both sites.
conclusionsThe results of this study reinforce that duodenal bulb samples are critically important for diagnosing CD in paediatric patients. We suggest that duodenal bulb samples be submitted in separate containers from distal duodenal samples to facilitate accurate interpretation. In contrast to prior reports, we found villous blunting and intraepithelial lymphocytosis are actually uncommon findings in paediatric patients with nonceliac gastrointestinal disorders.
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