Morphologic Spectrum of Duodenal Biopsies in Malabsorption: A Study from Southern IndiaCorrespondence Address :
Dr. Rajesh Nachiappa Ganesh,
Additional Professor, Department of Pathology, JIPMER, Puducherry-605006, India.
Introduction: Duodenal endoscopic biopsy is a common investigation for various non-neoplastic conditions. Malabsorption is a common indication for duodenal biopsy in our setting.
Aim: Our study was undertaken to study the morphologic spectrum of non-neoplastic conditions of duodenum emphasizing on Intraepithelial Lymphocytes (IELs) and to have a clinico-pathologic correlation.
Materials and Methods: This was a prospective descriptive study. Duodenal biopsies from 101 patients with symptoms of malabsorption were studied according to inclusion and exclusion criteria. Informed written consent was taken. Clinical, laboratory, endoscopic, and serological parameters were collected wherever available. Histomorphological parameters were studied on Haematoxylin and Eosin (H&E) stained sections. Intraepithelial lymphocyte counts were done on CD3, CD4 and CD8 Immunohistochemical (IHC) stained sections and correlated.
Results: We studied 101 duodenal biopsies. Our spectrum included 16 patients of celiac disease (CD) (15.8%), 15 autoimmune duodenitis (14%), 13 nutritional deficiency associated duodenitis (12.8%), 5 infectious duodenitis (5%) and 41 patients of non-specific duodenitis (40.6%). Villous crypt architecture, IEL counts; villous tip IEL counts were statistically significant between CD and other disease groups.
Conclusion: A constellation of clinical, serological, endoscopic and histopathologic features is essential in diagnosing celiac disease and autoimmune duodenitis. Biopsy is also a useful tool in diagnosing infectious duodenitis that are missed in other investigations.
Celiac disease, Duodenum, Intraepithelial lymphocyte
Priyavadhana Balasubramanian, Bhawana Ashok Badhe, Rajesh Nachiappa Ganesh, Lakshmi C Panicker, Pazhanivel Mohan. MORPHOLOGIC SPECTRUM OF DUODENAL BIOPSIES IN MALABSORPTION: A STUDY FROM SOUTHERN INDIA. Journal of Clinical and Diagnostic Research [serial online] 2017 July [cited: 2017 Sep 20 ]; 11:EC17-EC21. Available from
Date of Submission: Sep 01, 2016
Date of Peer Review: Oct 24, 2016
Date of Acceptance: Apr 17, 2017
Date of Publishing: Jul 01, 2017
Financial OR OTHER COMPETING INTERESTS: None.
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