The role of duodenal bulb biopsy in the diagnosis of celiac disease in children

Journal of Clinical Gastroenterology
Rachel Levinson-CastielRaanan Shamir

Abstract

It is suggested that for celiac disease (CD) diagnosis, biopsies should also be taken from the duodenal bulb. Whether bulb biopsies suggestive of CD can be found on upper gastrointestinal endoscopy (EGD) done for reasons other than CD diagnosis is not clear. The aim of our study was to evaluate the contribution of routine bulb biopsies to the diagnosis of CD, when taken regardless of prior suspicion of CD. The study included 96 children who underwent EGD for suspected CD and a control group of 69 children who underwent EGD for reasons other than CD. The mucosal changes were evaluated using the Marsh-Oberhuber classification. Among the 87 children diagnosed with CD, we identified 6 patients (7%) with typical histologic findings only in the bulb (Marsh 3), but also 1 patient (1.1%) with findings only in the distal duodenum (Marsh 2). In 20 patients (23%) the histological changes were more severe in the bulb. One patient had more prominent findings in the second part of the duodenum. None of the control patients had histological changes compatible with CD in the bulb or the second part of the duodenum. Our findings suggest that when CD is suspected, biopsies should be taken from both locations (bulb and second part) as mucosal cha...Continue Reading

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Citations

Dec 17, 2014·Current Problems in Pediatric and Adolescent Health Care·Joseph LevyNicole Silber
Sep 7, 2013·Advances in Pediatrics·Pierre Russo
May 26, 2012·Gastrointestinal Endoscopy·Matthew KurienDavid S Sanders
Jun 28, 2011·Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology·Margherita BonamicoMarzia Duse
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Feb 26, 2013·Journal of Paediatrics and Child Health·Ajay SharmaMadhur Ravikumara
Oct 19, 2016·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Samantha A StovenJoseph A Murray
Apr 28, 2012·Immunopharmacology and Immunotoxicology·Maria Elisabetta BaldassarreNicola Laforgia
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Dec 22, 2016·Expert Review of Gastroenterology & Hepatology·Luca ElliGovind K Makharia
Feb 13, 2018·Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology·Bhanwar Singh DhandhuSandeep Nijhawan
Sep 22, 2011·Journal of Clinical Gastroenterology·Raffaella NennaFabio Massimo Magliocca
Aug 3, 2016·The American Journal of Gastroenterology·Matthew KurienDavid S Sanders
May 7, 2015·Journal of Pediatric Gastroenterology and Nutrition·Sylvia OfeiIvor Hill
Nov 10, 2018·Endoscopy International Open·Thomas R McCartyTarun Rustagi
May 15, 2020·Virchows Archiv : an International Journal of Pathology·Hilal ÖzakıncıArzu Ensari
Apr 1, 2015·The American Journal of Gastroenterology·Dominica GidrewiczJ Decker Butzner
Oct 13, 2018·Digestive Diseases and Sciences·Reut DoyevAnat Yerushalmy-Feler
Sep 10, 2020·Journal of the Canadian Association of Gastroenterology·Erin BoscheeJason Yap

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