Accurate Diagnosis of Villous Atrophy in Celiac Disease Using Confocal Laser Endomicroscopy

Celiac disease (CD) is a gluten-sensitive enteropathy characterized by diffuse damage to the proximal small intestinal mucosa that results in malabsorption of most nutrients. CD is considered to affect at least 1% of the Western population. However, CD remains frequently missed and untreated (1). Endoscopic findings in CD include a mosaic pattern in the duodenal mucosa, scalloping and loss of duodenal folds. However, the overall sensitivity and positive predictive value of these endoscopic signs for the diagnosis of CD is poor (2). Therefore, the diagnosis of CD relies on histological assessment of duodenal biopsies supporting positive serology.