"Small intestinal biopsy and anti endomyosial sorologic test in children suspicious for celiac disease: a comparative study in Children Medical Center "

Abstract

Background: Celiac is one the most common causes of malabsorption and is an autoimmune disorder resulting in damage to intestinal epithelial cells by self T lymphocytes. The main culprit is gluten. The aim of our study was to assess the histopathologic findings of patients suspicious to have celiac disease in their first admission and compare them with serologic findings (endomyosial antibody test: EMA). Methods: The study is a prospective descriptional type and 95 patients suspicious to have celiac disease were included who went under upper endoscopy and sampling and also serologic studies. Histopathologic findings were grouped by Marsh classification. Specimens in Marsh stage 0 and 1 were also stained for leukocyte common antigen by immunohistochemistry Results: Ninety five patients, 49 males and 46 females, ranging from 9 months to 17 years (mean: 6.3 ys) were included in the study The most common complaint was abdominal pain. EMA test was positive in 43 patients. Most specimens were categorized as Marsh stage IIIA (51 cases) by histopatholgic examination, which can be seen in many other conditions. Only 16 patients were categorized as Marsh stage IIIB & IIIC, which are seen in established celiac patients No significant correlation was found between histopathologic and serologic findings. No difference was found between H&E staining and immunohistochemical staining in counting of intra- epithelial lymphocytes. Conclusion: Most of our patients had mild partial villous atrophy which is also seen in many other disorders and also EMA test was negative in this group. It appears that current assessment of celiac disease has many drawbacks and necessity of more specific methods is highly appreciated.

Keywords

• Anti endomyosial antibody test
• Marsh stage