The histological features of the coeliac disease include all of the following Except –
Correct Answer: Increase in thickness of the mucosa
Description: In celiac disease, the proximal intestine is commonly involved while in tropical sprue whole of the intestine is involved.
Biopsy of intestine in celiac sprue demonstrates.
Villous atrophy, loss of microvilli brush border
The crypts are hyperplastic and become elongated.
Presence of following cells on lamina propria → Plasma cells, Lymphocytes, Macrophages, Eosinophils, Mast cells.
Remember that overall mucosal thickness remains same in celiac sprue
Celiac ds. is associated with dermatitis herpetiformis.
Pathological features
Celiac disease is caused by the action of acidic peptides containing the gliadin fraction of wheat.
The basic abnormality is thought to be an increased rate of loss of epithelial cells. Crypt cells show increased activity. This causes hypertrophy of crypt. But even this increased activity cannot keep pace with the loss of cells, resulting in a progressive decrease in height of villi causing villous atrophy
The epithelial cells show decreased cytoplasm and mucus
The intestinal biopsy shows decreases in the villus: crypt ratio. Normally the villi are 3-4 times the height of the crypts (ratio of 3-4: 1); in celiac disease, the ratio decreases progressively (partial, subtotal and total villous atrophy). Total villous atrophy is seen in severe celiac ds and is quite characteristic of celiac ds (partial villous atrophy may be seen in many other conditions).
Category:
Pediatrics
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