Modified Marsh...

Modified Marsh classification of the duodenal biopsies of a large database covering 10 years  Cansu Abaylı, Figen Doran, Bahri Abaylı, Oğuz ÜSKÜDAR


Celiac is an autoimmune disease caused by of gluten proteins which can be found in multi-grain food like wheat, barley and oat. The disease affects more than 1% of population and characterized by intestinal inflammation (1-2). In celiac disease, mucosal damage is a dynamic process. It is shown that it has autoimmune components. It is also T-Cell mediated and can be categorised as a chronic inflammatory disease. The purpose of this study is to make modified Marsh classification of the duodenal biopsies that came to our department in the 10 years. The study deals with reassessment of all events and uncovering the low graded events that were not diagnosed. Methods: 467 biopsies (diagnosed between 2001 and 2011 at the Cukurova University, Faculty of Medicine, Department of Pathology) were taken and analyzed by two pathologists. Each sample was reevaluated without taking the previous reports into consideration and scored by using modified Marsh classification (Table 1). Results: According to Modified Marsh Classification (MMC) total of 48 cases were diagnosed as Type 1 (Figure 1). Total of 6 cases according to MMC was diagnosed as Type 2 (Figure 2). Total of 11 cases according to MMC was diagnosed as Type 3a (Figure 3). Total of 5 cases, according to MMC, was diagnosed as Type 3b. Total of 6 cases according to MMC was diagnosed as Type 3c. Conclusions: As a result of this study, it has been found that MMC is a very important standardization tool for detection of suspicious duodenal biopsies and for early case examinations.

Key words:Modified Marsh classification, duodenal biopsies, celiac disease


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Uzm.Dr. Bahri ABAYLI