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Features:<ref name=Ref_PBoD843>{{Ref PBoD|843}}</ref> | Features:<ref name=Ref_PBoD843>{{Ref PBoD|843}}</ref> | ||
*Enteritis. | *Enteritis. | ||
**Intraepithelial lymphocytes | **Intraepithelial lymphocytes - '''key feature'''. | ||
**Plasma cells. | **Plasma cells. | ||
**Macrophages. | **Macrophages. | ||
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**Normal duodenal biopsy should have 3 good villi. | **Normal duodenal biopsy should have 3 good villi. | ||
*Mitosis increased (in the crypts). | *Mitosis increased (in the crypts). | ||
*+/-Collagen band (pink material in mucosa) - "Collagenous sprue"; must encompass ~25% of mucosa. | |||
Image: | Image: | ||
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*If you see acute inflammatory cells, i.e. neutrophils, consider Giardiasis and other infectious etiologies. | *If you see acute inflammatory cells, i.e. neutrophils, consider Giardiasis and other infectious etiologies. | ||
*Biopsy should consist of 2-3 sites. In children it is important to sample the duodenal cap, as it is the only affected site in ~10% of cases. | *Biopsy should consist of 2-3 sites. In children it is important to sample the duodenal cap, as it is the only affected site in ~10% of cases. | ||
*Flat lesions without IELs are unlikely to be celiac | *Flat lesions without IELs are unlikely to be celiac sprue. | ||
===Grading=== | ===Grading=== |
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