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Date: | Mon, 28 Sep 1998 23:34:22 -0400 |
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<<Disclaimer: Verify this information before applying it to your situation.>>
Joanne E Hameister wrote:
>At the Canadian Celiac Conference in Montreal in 1996, it was noted that
>8-15% of biopsies might (I emphasize 'might') produce false negative
>results. According to my doctor, this lack of sensitivity is a sampling
>error, ex. the doctor not taking a sufficient number of samples and/or
>not sampling in the appropriate area of the jejunum.
You also have to include a varied interpretation of the biopsy slides. As
you can see below there is a progression in how the mucosa becomes damaged
(which is actually reversed below). It is my understanding that many
pathologists in the US have a rather high standard before they make a
diagnosis. A high standard being only the first of the five criteria are
used to make a diagnosis.
Taken from THE SPRUE-NIK PRESS, September 1995
The University of Maryland School of Medicine sponsored a conference
on July 14-15, 1995 entitled "Celiac Disease: The Dark Side of the
Gastrointestinal Planet". [snipped...]
..........................................................
: Pathology of Celiac Disease :
: --------------------------- :
: by Salvatore Auricchio, MD summarized by Jim Lyles :
:........................................................:
Dr. Auricchio is Professor and Chairman of Pediatrics at the
University Frederico II in Naples, Italy.
CD manifests itself in the small intestine. A distinct pattern of
abnormalities has been observed [comments in braces have been added by
Jim Lyles]:
* villous atrophy [partial or complete flattening of the
finger-like projections in the small intestine]
* hyperplasia of the crypts of Lieberkuhn [the crypts under the
villi become highly elongated when compared with normal crypts]
* increased plasma cell and lymphocyte infiltration of the lamina
propria [more lymphocytes under the epithelial or outer layer of
the villi. Lymphocytes are the cells that fight off viruses,
etc.]
* increased intraepithelial lymphocytes [more lymphocytes within
the epithelial cells. The epithelial cells form the outer layer
of the intestine and allow nutrients to pass through from the
intestine into the bloodstream]
* abnormalities in the epithelial cells which become flattened,
cuboidal, and pseudo- stratified [layered].
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