title: Microscopic enteritis: Bucharest consensus.
abstract: Microscopic enteritis (ME) is an inflammatory condition of the small bowel that leads to gastrointestinal symptoms, nutrient and micronutrient deficiency. It is characterised by microscopic or sub-microscopic abnormalities such as microvillus changes and enterocytic alterations in the absence of definite macroscopic changes using standard modern endoscopy. This work recognises a need to characterize disorders with microscopic and submicroscopic features, currently regarded as functional or non-specific entities, to obtain further understanding of their clinical relevance. The consensus working party reviewed statements about the aetiology, diagnosis and symptoms associated with ME and proposes an algorithm for its investigation and treatment. Following the 5(th) International Course in Digestive Pathology in Bucharest in November 2012, an international group of 21 interested pathologists and gastroenterologists formed a working party with a view to formulating a consensus statement on ME. A five-step agreement scale (from strong agreement to strong disagreement) was used to score 21 statements, independently. There was strong agreement on all statements about ME histology (95%-100%). Statements concerning diagnosis achieved 85% to 100% agreement. A statement on the management of ME elicited agreement from the lowest rate (60%) up to 100%. The remaining two categories showed general agreement between experts on clinical presentation (75%-95%) and pathogenesis (80%-90%) of ME. There was strong agreement on the histological definition of ME. Weaker agreement on management indicates a need for further investigations, better definitions and clinical trials to produce quality guidelines for management. This ME consensus is a step toward greater recognition of a significant entity affecting symptomatic patients previously labelled as non-specific or functional enteropathy.
authors.affiliation: Kamran Rostami, David Aldulaimi, Luke Materacki, Department of Gastroenterology, Alexandra Hospital, Worcestershire B98 7UB, United Kingdom.
authors.forename: Kamran
authors.initials: K
authors.lastname: Rostami
authors.affiliation: Kamran Rostami, David Aldulaimi, Luke Materacki, Department of Gastroenterology, Alexandra Hospital, Worcestershire B98 7UB, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Aldulaimi
authors.affiliation: Kamran Rostami, David Aldulaimi, Luke Materacki, Department of Gastroenterology, Alexandra Hospital, Worcestershire B98 7UB, United Kingdom.
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Holmes
authors.affiliation: Kamran Rostami, David Aldulaimi, Luke Materacki, Department of Gastroenterology, Alexandra Hospital, Worcestershire B98 7UB, United Kingdom.
authors.forename: Matt W
authors.initials: MW
authors.lastname: Johnson
authors.affiliation: Kamran Rostami, David Aldulaimi, Luke Materacki, Department of Gastroenterology, Alexandra Hospital, Worcestershire B98 7UB, United Kingdom.
authors.forename: Marie
authors.initials: M
authors.lastname: Robert
authors.affiliation: Kamran Rostami, David Aldulaimi, Luke Materacki, Department of Gastroenterology, Alexandra Hospital, Worcestershire B98 7UB, United Kingdom.
authors.forename: Amitabh
authors.initials: A
authors.lastname: Srivastava
authors.affiliation: Kamran Rostami, David Aldulaimi, Luke Materacki, Department of Gastroenterology, Alexandra Hospital, Worcestershire B98 7UB, United Kingdom.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Fléjou
authors.affiliation: Kamran Rostami, David Aldulaimi, Luke Materacki, Department of Gastroenterology, Alexandra Hospital, Worcestershire B98 7UB, United Kingdom.
authors.forename: David S
authors.initials: DS
authors.lastname: Sanders
authors.affiliation: Kamran Rostami, David Aldulaimi, Luke Materacki, Department of Gastroenterology, Alexandra Hospital, Worcestershire B98 7UB, United Kingdom.
authors.forename: Umberto
authors.initials: U
authors.lastname: Volta
authors.affiliation: Kamran Rostami, David Aldulaimi, Luke Materacki, Department of Gastroenterology, Alexandra Hospital, Worcestershire B98 7UB, United Kingdom.
authors.forename: Mohammad H
authors.initials: MH
authors.lastname: Derakhshan
authors.affiliation: Kamran Rostami, David Aldulaimi, Luke Materacki, Department of Gastroenterology, Alexandra Hospital, Worcestershire B98 7UB, United Kingdom.
authors.forename: James J
authors.initials: JJ
authors.lastname: Going
authors.affiliation: Kamran Rostami, David Aldulaimi, Luke Materacki, Department of Gastroenterology, Alexandra Hospital, Worcestershire B98 7UB, United Kingdom.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Becheanu
authors.affiliation: Kamran Rostami, David Aldulaimi, Luke Materacki, Department of Gastroenterology, Alexandra Hospital, Worcestershire B98 7UB, United Kingdom.
authors.forename: Carlo
authors.initials: C
authors.lastname: Catassi
authors.affiliation: Kamran Rostami, David Aldulaimi, Luke Materacki, Department of Gastroenterology, Alexandra Hospital, Worcestershire B98 7UB, United Kingdom.
authors.forename: Mihai
authors.initials: M
authors.lastname: Danciu
authors.affiliation: Kamran Rostami, David Aldulaimi, Luke Materacki, Department of Gastroenterology, Alexandra Hospital, Worcestershire B98 7UB, United Kingdom.
authors.forename: Luke
authors.initials: L
authors.lastname: Materacki
authors.affiliation: Kamran Rostami, David Aldulaimi, Luke Materacki, Department of Gastroenterology, Alexandra Hospital, Worcestershire B98 7UB, United Kingdom.
authors.forename: Kamran
authors.initials: K
authors.lastname: Ghafarzadegan
authors.affiliation: Kamran Rostami, David Aldulaimi, Luke Materacki, Department of Gastroenterology, Alexandra Hospital, Worcestershire B98 7UB, United Kingdom.
authors.forename: Sauid
authors.initials: S
authors.lastname: Ishaq
authors.affiliation: Kamran Rostami, David Aldulaimi, Luke Materacki, Department of Gastroenterology, Alexandra Hospital, Worcestershire B98 7UB, United Kingdom.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Rostami-Nejad
authors.affiliation: Kamran Rostami, David Aldulaimi, Luke Materacki, Department of Gastroenterology, Alexandra Hospital, Worcestershire B98 7UB, United Kingdom.
authors.forename: A Salvador
authors.initials: AS
authors.lastname: Peña
authors.affiliation: Kamran Rostami, David Aldulaimi, Luke Materacki, Department of Gastroenterology, Alexandra Hospital, Worcestershire B98 7UB, United Kingdom.
authors.forename: Gabrio
authors.initials: G
authors.lastname: Bassotti
authors.affiliation: Kamran Rostami, David Aldulaimi, Luke Materacki, Department of Gastroenterology, Alexandra Hospital, Worcestershire B98 7UB, United Kingdom.
authors.forename: Michael N
authors.initials: MN
authors.lastname: Marsh
authors.affiliation: Kamran Rostami, David Aldulaimi, Luke Materacki, Department of Gastroenterology, Alexandra Hospital, Worcestershire B98 7UB, United Kingdom.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Villanacci
mesh_terms: D000465:Algorithms; D015897:Comorbidity; D032921:Consensus; D019091:Critical Pathways; D004751:Enteritis / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D007408:Intestinal Absorption; D007421:Intestine, Small / Q000473:pathology / Q000503:physiopathology; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors
keywords: Bucharest consensus; Enteropathy; Gluten; Malabsorption; Microscopic enteritis; Non-celiac gluten