Dergiler / Turkish Journal of Gastroenterology / 2019 / Cilt: 30 - Sayı: 5

Diagnosing celiac disease: A critical overview

Sayfa
389–397
DOI
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⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

A promising alternative would be to hear more voices from imaginative histopathologistsor morphologists together with some more insightful approaches, involving molecular-based techniques and stem cell research may be toevaluate mucosal pathology in CD.

📌 3 Maddede Bu Makale

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Amaç & Hipotez:The diagnosis of celiac disease (CD) no longer rests on a malabsorptive state or severe mucosal lesions.
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Temel Bulgular & Veri:Morever, the subclassification of Marsh 3 imposed an enormous amount of extra work onpathologists with no aid in diagnosis, treatment, or prognosis.
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Sonuç & Katkı:A promising alternative would be to hear more voices from imaginative histopathologistsor morphologists together with some more insightful approaches, involving molecular-based techniques and stem cell research may be toevaluate mucosal pathology in CD.
🔬Tür:Araştırma Makalesi
📍Kapsam:Genişletilmiş Akademik Örneklem
⚙️Değişkenler:Alan Parametreleri

Özet

The diagnosis of celiac disease (CD) no longer rests on a malabsorptive state or severe mucosal lesions. For the present, diagnosis will alwaysrequire the gold-standard of a biopsy, interpreted through its progressive phases (Marsh classification). Marsh classification articulatedthe immunopathological spectrum of gluten-induced mucosal changes in association with the recognition of innate (Marsh I infiltration)and T cell-based adaptive (Marsh II, and the surface re-organisation typifying Marsh III lesions) responses. Through the Marsh classificationthe diagnostic goalposts were considerably widened thus, over its time-course, permitting countless patients to begin a gluten-free dietbut who, on previous criteria, would have been denied such vital treatment. The revisions of this classification failed to provide additionalinsight in the interpretation of mucosal pathology. Morever, the subclassification of Marsh 3 imposed an enormous amount of extra work onpathologists with no aid in diagnosis, treatment, or prognosis. Therefore, it should now be apparent that if gastroenterologists ignore thesesub-classifications in clinical decision-making, then on that basis alone, there is no need whatsoever for pathologists to persist in reportingthem. Since new treatments are under critical assessment, we might have to consider use of some other higher level histological techniquessensitive enough to detect the changes sought. A promising alternative would be to hear more voices from imaginative histopathologistsor morphologists together with some more insightful approaches, involving molecular-based techniques and stem cell research may be toevaluate mucosal pathology in CD.

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Bu Makaleye Atıf Yap

ENSARİ, A., MARSH, M. N. (2019). Diagnosing celiac disease: A critical overview. Turkish Journal of Gastroenterology, Cilt: 30 - Sayı: 5, 389–397. https://ajindex.com/articles/409245

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Kaynakça (17)

  1. Morena M, Gatti R. A history of bone marrow trephine. Immunol Allerg Clin North Am 2010
  2. [CrossRef] 2. Iversen P, Brun C. Aspiration biopsy of the kidney. Am J Med 1951
  3. [CrossRef] 3. Menghini G. One-second needle biopsy of the liver. Gastroenterology 1958
  4. Wood I, Doig R, Motteram R, Hughes A. Gastric biopsy: report on fifty-five biopsies using a new flexible gastric biopsy tube. Lancet 1949
  5. [CrossRef] 5. Crosby W, Kugler H. Intraluminal biopsy of the small intestine. The intestinal biopsy capsule. Dig Dis Sci 1957
  6. [CrossRef] 6. Sakula J, Shiner M. Coeliac disease with atrophy of the small-intestine mucosa. Lancet 1957
  7. [CrossRef] 7. Marsh MN. Mucosal pathology in gluten sensitivity. In: Marsh MN, ed. Coeliac Disease. Oxford: Blackwell Scientific Publications
  8. P. 136. 8. Shiner M, Doniach I. Histopathologic studies in steatorrhea. Proc World Congr Gastroenterol. Washington [DC]. Baltimore: The Williams & Wilkins Company, 1959: P. 586. 9. Baker S. Idiopathic small intestinal disease in the tropics. In: Chandra RK, ed. Critical Reviews in Tropical Medicine (Vol. 1). New York [NY]: Plenum Press 1982
  9. P. 197. [CrossRef] 10. Anderson C. Histological changes in the duodenal mucosa in coeliac disease: reversibility during treatment with a gluten-free diet. Arch Dis Child 1960
  10. [CrossRef] 11. Cocco A, Dohrmann M, Hendrix T. Reconstruction of normal jejunal biopsies: three-dimensional histology. Gastroenterology 1996
  11. Ensari A, Marsh MN. Exploring the Villus. Gastroenterology Hepatology from Bed to Bench 2018
  12. Creamer B, Leppard P. Post-mortem examination of a small intestine in the coeliac syndrome. Gut 1965
  13. [CrossRef] 14. Loehry C, Creamer B. Three-dimensional structure of the human small intestinal mucosa in health and disease. Gut 1969
  14. [CrossRef] 15. Toner P, Carr K, Ferguson A, Mackay C. Scanning and transmission electron microscopic studies of the human small intestinal in health and disease. Gut 1970
  15. [CrossRef] 16. Holmes R, Hourihane O’B, Booth C. The mucosa of the small intestine. Postgrad Med J 1961
  16. [CrossRef] 17. Padykula H, Stauss E, Ladman A, Gardner F. A morphological and histochemical analysis of the normal human jejunal epithelium in nontropical sprue. Gastroenterology 1961
  17. Taavela J, Koskinen O, Huhtala H, et al. Validation of morphometric analyses of small-intes