Celiac sprue diagnosis | PGIMER MCQs for MD MS Preparations

Celiac sprue is diagnosed by 

A. Intestinal biopsy 
B. Unequivocal response to gluten restriction 
C. Finding of organism 
D. Improvement on dapsome treatment 
E. H/O fat malabsorption

Ans. B. Unequivocal response to Gluten resriction :

• The diagnosis of celiac spure requires the presence of characteristic hisotpatholocic changes on small intestinal biopsy together with a prompt Clinical and histopathological response following 

the institution of gluten-free diet. 

The changes seen on duodenum/jujunal biopsy are restricted to muscosa and includes-

(i) Absence or reduced height of villi, resulting a “flat” appearance. 

(ii) Increased loss of villus cells in association with ted crypt cell proliferation resulting in crypt hyperplasia and loss of villous structure, with consequent villus but not mucosal atrophy. 

(iii) Cuboidal appearance and nuclei that are oriented basally in surface epithelial cells and increased intraepithelial lymphocytes. 

(iv) increased lymphocytes and plasma cells in the lamina propria. 

• Although histopathological features are characteristic celiac sprue but not diagnostic as similar appearance is seen in — Tropical sprue, eosinophilic enteritis, milk-protein intolerance in children and occasionally in lymphoma, bacterial over growth, Crohn’s disease and gastrinoma with acid hypersecretion.