Document Detail

Endoscopic demonstration of loss of duodenal folds in the diagnosis of celiac disease.
MedLine Citation:
PMID:  3412397     Owner:  NLM     Status:  MEDLINE    
Among 873 patients undergoing upper gastrointestinal endoscopy for various reasons over a two-year period, four had a loss of Kerckring's folds in the descending duodenum. Endoscopic duodenal biopsy in all four patients revealed subtotal villous atrophy due to celiac disease. We undertook a prospective study to evaluate the extent to which this finding predicted celiac disease in 65 consecutive patients referred for intestinal biopsy. Duodenal folds were absent or markedly decreased in 15 of 17 patients with subtotal villous atrophy and in 8 of 48 patients with partial villous atrophy or normal duodenal mucosa, giving a sensitivity of 88 percent and a specificity of 83 percent for this endoscopic finding with respect to celiac disease. We recommend that all patients undergoing upper gastrointestinal endoscopy be examined for the loss or reduction of duodenal folds and, should this be found, that the examination include duodenal biopsy. The value of this procedure as an aid in the diagnosis of celiac disease should be particularly great in patients with minimal, transient, or unrelated symptoms.
E Brocchi; G R Corazza; G Caletti; E A Treggiari; L Barbara; G Gasbarrini
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The New England journal of medicine     Volume:  319     ISSN:  0028-4793     ISO Abbreviation:  N. Engl. J. Med.     Publication Date:  1988 Sep 
Date Detail:
Created Date:  1988-10-11     Completed Date:  1988-10-11     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0255562     Medline TA:  N Engl J Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  741-4     Citation Subset:  AIM; IM    
I Patologia Medica, Policlinico S. Orsola, Università di Bologna, Italy.
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MeSH Terms
Celiac Disease / diagnosis*,  pathology
Duodenum / pathology*
Intestinal Mucosa / pathology
Prospective Studies
Comment In:
N Engl J Med. 1989 Jul 27;321(4):263-4   [PMID:  2590285 ]

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