Table 3.

Classification of Intestinal Lesions in Celiac Disease

TypeMucosal Findings
Stage 0. Preinfiltrative stageNormal 1
Stage 1. Infiltrative lesion 1Increased intraepithelial lymphocytes
Stage 2. Hyperplastic lesionStage 1 changes plus hyperplastic crypts
Stage 3. Destructive lesion 2Stage 2 changes plus:
  • Partial villous atrophy (termed 3a)
  • Subtotal villous atrophy (3b)
  • Total villous atrophy (3c)
Stage 4. Hypoplastic lesion 3Total villous atrophy with crypt hypoplasia
1.

Small-bowel biopsy can fail to detect histologic changes in the following circumstances: gluten-free diet, early stages of the disease, patchy mucosal lesions, masking of celiac effect by peptic changes, insufficient number of samples taken, latent celiac disease.

2.

Comparisons with other classifications are detailed in Ludvigsson et al [2013].

From: Celiac Disease

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