Critical Medicine and Treatment

Diagnosis is made by measuring specific antibodies in the blood, a biopsy of the intestine and symptoms. Duodenal biopsy is often, but will be more sensitive to the jejunum.

Are three different models that vary according to clinical presentation:

Villous epithelial infiltration with lymphocytes, with normal villi and crypts. This model was found in 40% of individuals with Dermatitis Herpetiformis and a small portion of patients with bowel involvement and affected relatives are asymptomatic. Elongation of the crypts and flattening and inflammatory cells in the lamina propria. This model is classically in individuals with celiac disease with intestinal symptoms in asymptomatic affected relatives, and individuals with dermatitis herpetiformis. In most of these individuals, treatment with a gluten-free diet results in improvement of the villi and crypts architecture that becomes normal or nearly normal.

Complete flattening of the mucosa with absence of villi and crypts very small. It is found in more severely affected patients. It is often refractory to gluten-free diet, and the injury is not reversible. Are patients requiring intravenous nutrition supplements. Property and repeated biopsy to avoid false positives of intestinal infections, with lesions caused by lactose. We must also bear in mind that patients in remission or with intermittent symptoms may have normal biopsy and the results of the analysis but remain very sensitive to any prolamin.

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