Compare the intestinal biopsy specimen of patient before and after diet restriction. All the true about the condition shown except:
Correct Answer: Classic changes in celiac sprue occur in submucosa
Description: (Atrophy of villi) (Regeneration of villi) IgA tissue transglutaminase (IgA tTG) antibody is recommended; has a 95% sensitivity and 95% specificity for detecting celiac disease. Antigliadin antibodies are not recommended because of their lower sensitivity and specificity .IgA antiendomysial antibodies are no longer recommended due to the lack of standardization among laboratories. Celiac disease is associated with dermatitis herpetiformis (DH), but this association has not been explained. Patients with DH have characteristic papulovesicular lesions that respond todapsone. Almost all patients with DH have histologic changes in the small intestine consistent with celiac disease, although usually much milder and less diffuse in distribution. The most impoant complication of celiac disease is the development of cancer. The incidences of both gastrointestinal and nongastrointestinal neoplasms as well as intestinal lymphoma are elevated among patients with celiac disease. The classic changes seen on duodenal/jejunal biopsy are restricted to the mucosa and include An increase in the number of intraepithelial lymphocytes; absence or a reduced height of villi a cuboidal appearance and nuclei that are no longer oriented basally in surface epithelial cells; and increased numbers of lymphocytes and plasma cells in the lamina propria .
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