title: Small bowel villous atrophy: celiac disease and beyond.
abstract: Small bowel villous atrophy can represent a diagnostic challenge for gastroenterologists and pathologists. In Western countries small bowel atrophy and mild non-atrophic alterations are frequently caused by celiac disease. However, other pathology can mimic celiac disease microscopically, widening the differential diagnosis. The several novelties on this topic and the introduction of the device-assisted enteroscopy in the diagnostic flowchart make an update of the literature necessary. Areas covered: In this review, a description of the different clinical scenarios when facing with small bowel mucosal damage, particularly small bowel atrophy, is described. The published literature on this subject has been summarized and reviewed. Expert commentary: When an intestinal mucosal alteration is histologically demonstrated, the pathology report forms part of a more complex workup including serological data, clinical presentation and clinical history. A multidisciplinary team, including pathologists and enteroscopy-devoted endoscopists, is frequently required to manage patients with small bowel alterations, especially in cases of severe malabsorption syndrome.
authors.affiliation: a Center for Prevention and Diagnosis of Celiac Disease , Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , Milano , Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Elli
authors.affiliation: a Center for Prevention and Diagnosis of Celiac Disease , Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , Milano , Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Branchi
authors.affiliation: b Department of Gastroenterology , University of Sheffield, Royal Hallamshire Hospital , Sheffield , United Kingdom.
authors.forename: Reena
authors.initials: R
authors.lastname: Sidhu
authors.affiliation: c Department of Pediatrics, Section of Pediatric Gastroenterology , Hepatology and Nutrition, Celiac Disease Center, University of Chicago , Chicago , IL , USA.
authors.forename: Stefano
authors.initials: S
authors.lastname: Guandalini
authors.affiliation: d Prince Abdullah Bin Khalid Coeliac Disease Research Chair King Saud University , Riyadh , Saudi Arabia.
authors.forename: Asaad
authors.initials: A
authors.lastname: Assiri
authors.affiliation: e Institute for Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center , Petach Tikva , Israel.
authors.forename: Firas
authors.initials: F
authors.lastname: Rinawi
authors.affiliation: f Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach Tikva, Israel AND Sackler Faculty of Medicine , Tel-Aviv University , Tel Aviv , Israel.
authors.forename: Raanan
authors.initials: R
authors.lastname: Shamir
authors.affiliation: g Department of Pathology , All India Institute of Medical sciences , New Delhi , India.
authors.forename: Prasenjit
authors.initials: P
authors.lastname: Das
authors.affiliation: h Department of Gastroenterology and Human Nutrition , All India Institute of Medical Sciences , New Delhi , India.
authors.forename: Govind K
authors.initials: GK
authors.lastname: Makharia
mesh_terms: D001284:Atrophy; D001706:Biopsy; D002446:Celiac Disease / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D003937:Diagnosis, Differential; D016099:Endoscopy, Gastrointestinal; D006801:Humans; D006965:Hyperplasia; D007413:Intestinal Mucosa / Q000473:pathology*; D007421:Intestine, Small / Q000473:pathology*; D011237:Predictive Value of Tests; D011379:Prognosis
keywords: Small bowel atrophy; autoimmune enteritis; celiac disease; enteritis; gluten; infections