XXXX and 'normal' histology: is the intestinal mucosa really normal?

@entity1 @entity1931 @entity1593 @entity75
BACKGROUND: Early pathogenetic events of @entity1931 may be overlooked in @entity1 with serologic markers of @entity1593 and normal intestinal mucosa by both conventional histology and immunohistochemistry. AIMS: To investigate if a submicroscopical damage of the absorptive cell surface was associated with developing @entity1593 . @entity1 AND METHODS: Duodenal biopsies of seven subjects with positive anti-endomysial antibodies and normal histology underwent ultrastructural evaluation of the epithelial surface by means of both scanning and transmission electron microscopy. Specimens of intestinal mucosa of 14 @entity1 with non-celiac conditions were used as controls. RESULTS: In four @entity1 , electron microscopy revealed alterations of the enterocyte brush border with a significant reduction of the height of microvilli. After several months, three of them had a second biopsy that eventually showed histological modifications suggestive of @entity1593 . In the other three @entity1 , no significant alteration of enterocyte ultrastructure was observed. One of them, rebiopsied after 12 months, still showed a normal duodenal histology. CONCLUSIONS: @entity1593 can be associated with 'minimal' mucosal changes not detectable with conventional light microscopy. @entity75 , which primarily involve microvillous structure, may imply a reduction of intestinal absorptive surface already in the latent stage of the disease.
