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The biopsy pathology of non‐coeliac enteropathy
Author(s) -
Greenson Joel K
Publication year - 2015
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/his.12522
Subject(s) - coeliac disease , enteropathy , intraepithelial lymphocyte , malabsorption , villous atrophy , lamina propria , pathology , tropical sprue , biology , dermatitis herpetiformis , biopsy , medicine , immunology , gastroenterology , sprue , disease , epithelium , mold , genetics
Tropical sprue ( TS ) is a malabsorption syndrome of presumed infectious aetiology that affects residents of (or visitors to) the tropics. The histological changes of TS are similar to those of coeliac disease, with increased intraepithelial lymphocytes being central to both. Unlike in coeliac disease, however, a completely flat small bowel biopsy is uncommon in TS . TS typically involves the terminal ileum, whereas coeliac disease does not. Small intestinal bacterial overgrowth ( SIBO ) has been defined as an increase in number and/or a change in the type of bacteria in the upper gut. Conditions that predispose to SIBO are largely those that decrease or interfere with small bowel motility. The mucosal histology is variable, and may include modest villous blunting accompanied by increased lamina propria and epithelial inflammation. Autoimmune enteropathy ( AE ) is a family of rare diseases that share common themes such as immunodeficiency states and autoantibodies. AE cases typically have marked villous atrophy similar to that in fully developed coeliac disease, but they lack the intense surface epithelial lymphocytosis. Apoptosis and lymphocyte infiltration at the base of the crypts, crypt abscesses and cryptitis are also seen. Patients with anti‐goblet cell antibodies can have a lack of goblet cells, endocrine cells, and Paneth cells.