Original article—alimentary tractComparison of the Interobserver Reproducibility With Different Histologic Criteria Used in Celiac Disease
Section snippets
Study Design and Case Selection
A panel of 60 slides of duodenal biopsy specimens were selected at the coordinating center by 2 pathologists (V.V. and C.Z.), who were responsible for the final diagnoses and for the appropriate quality of the biopsy specimens (these pathologists did not take part in the study). At least 4 biopsies were obtained from each patient from the second part of duodenum and properly positioned on millipore filters (Bio-Optica, Milan, Italy), because poor orientation is the major flaw in the histologic
Results
None of the pathologists taking part in the study notified the coordinating center of any concern as to the proper adequacy of the sections.
Discussion
CD is a gluten-dependent enteropathy characterized by high prevalence,15 increased morbidity,16 and increased mortality rate.17 This underlines the absolute need for a confident diagnosis, for which intestinal biopsy is still considered the gold standard. There is a wide consensus that a second biopsy, taken after gluten withdrawal and showing an unequivocal improvement of the duodenal histology, constitutes an essential confirmation.18, 19
However, the pathologic evaluation of CD is prone to
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