Histopathological findings in celiac disease patients enrolled for duodenal biopsy in Najran, Saudi Arabia: a 5-year retrospective study
Background: Celiac disease is an autoimmune condition characterized by serological and histopathological manifestations associated with gluten ingestion.
Aim: This report investigates histopathological findings in all celiac disease patients of both genders enrolled for duodenal biopsy from June 2015 to May 2020 in four centers in Najran, Saudi Arabia.
Methods: This retrospective study assessed data retrieved from archived histopathology records. The data were analyzed using Prism GraphPad 6. Categorical variables were examined using descriptive statistics, including frequency and percentages. A chi-square test was used to assess the association between gender and age, clinical presentation, and histopathological changes. Values of P < 0.05 were considered as significant.
Results: The study included 150 celiac disease patients, of whom 104 were female (69.3%), with most aged between 31 and 40 years (33.3%). Regarding clinical presentation, the majority of patients (62%) presented with gastrointestinal symptoms. Almost half of the duodenal biopsies (71 cases, 47.3%) showed shortened villi caused by partial atrophy, which is consistent with grade B1 according to Corazza and Villanaci criteria, and type 3A and 3B lesions according to the Marsh–Oberhuber classification. The second most frequent histopathological finding was an increased abundance of intraepithelial lymphocytes in the absence of villous atrophy, which was found in 56 biopsies (37.3%) and categorized as grade A.
Conclusions: Females are affected by celiac disease more than males in Najran, and the majority presented as having typical celiac disease with gastrointestinal symptoms. Most of the diagnosed cases of celiac disease ranged between grades A and B1, with less involvement of the severe degree grades B2 and 3C, according to Corazza and Villanaci’s criteria and the Marsh–Oberhuber classification. Despite the absence of any association between gender, age or clinical presentation, there were significant associations between gender and histopathological findings, grading, and classification of celiac disease lesions. Finally, the presence of asymptomatic patients (12.7%) indicates the importance of celiac disease screening.
Relevance for patients: This study might be considered a reference for pathologists assessing the duodenal biopsies for patients screened for celiac disease in Najran.
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