Duodenal biopsy in malabsorption-A clinicopathological study

To study the morphologic spectrum of duodenal biopsy specimens in malabsorption, to correlate the histology with clinical, endoscopic and serological investigations and to assess various aetiologies of malabsorption.

Duodenal biopsies of 50 patients presenting with symptoms of malabsorption were analysed over a period of one year. The clinical details of patients, including their routine blood investigations, serology for Serum tissue transglutaminase (IgA t TG) and Upper gastrointestinal (UGI) endoscopic findings were noted. The villous architecture, villous to crypt ratio (V: C ratio), crypt examination and Intraepithelial lymphocytes were counted. Other findings like presence of parasites, dilated lymphatics, granulomas were also noted down.

The mean age of presentation was 32.5 years, with a mild female preponderance. Endoscopic mucosal abnormalities were found in 42% of cases and microscopic villous atrophy in 46% of cases. Increase in IELs was found in 48% of cases. Celiac disease was the leading cause (28%) of malabsorption whereas Tropical sprue accounted for only 4% of cases. Not a single case of tuberculosis was encountered.