Clinical and Morphological Aspects of Celiac Disease

  • Anum Usman Assistant Professor,Department of Pathology, Al-Nafees Medical College and Hospital Islamabad
  • Noor Khan Lakhanna Professor/Head of Department,Department of Pathology, Al-Nafees Medical College and Hospital Islamabad
  • Mudassira Zahid Assistant Professor, Department of Pathology, Al-Nafees Medical College and Hospital Islamabad
  • Humaira Zafar Associate Professor Department of Pathology, Al-Nafees Medical College and Hospital Islamabad
Keywords: Celiac disease, Malabsorption, Morphology, Modified Marsch grades


Objective: To assess the clinical and morphological aspects of celiac disease.
Patients and Methods: This cross sectional study was conducted at Department of Pathology, Al Nafees Medical College & Hospital for a period of 8 months. After taking approval from Institutional review board, a written informed consent was taken from all the enrolled patients depending upon inclusion and exclusion criteria. Clinical data including the symptoms and signs and their severity was collected and entered on a specially designed proforma. Morphological data was collected with the help of patient’s endoscopic biopsy. Histopathological biopsies were graded according to modified Marsch grading system. For qualitative variables frequencies and percentages were calculated. Quantitative variables were measured in terms of mean and standard deviation.
Results: There were 77 patients with suspicion of celiac disease whose endoscopic biopsy was done. Among these 42% were males and 58 % were females. Maximum number of patients were in the age group of 13-30 years. Among symptoms, diarrhea was present in 83.11% (n=64) patients, abdominal distention and pain was present in 53% and 63.6% patients respectively. Lesser frequent symptoms including vomiting and weight loss was significant in only 16.9% patients and constipation in 14.3% patients. According to modified Marsch grades, maximum celiac patients were graded in Marsch-3a (15.6%) and Marsch-3b (19.5%).
Conclusion: Majority of patients with Celiac disease presented with typical gastrointestinal signs and symptoms in which diarrhea was the commonest complaint. The disease is more common in adults with female predominance. Majority of patients belong to the 3a and 3b type lesion of the modified Marsch grading system.

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