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8 Cards in this Set
- Front
- Back
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Normal SI histology
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Villi prominent with smaller crypt component
Normal villous-crypt ratio is 3-5:1 Surface cells mostly columnar absorptive cells with brush border Goblet cells present Less than 10 IEL/100 epithelial cells Brunner’s glands in duodenum Peyer’s patches in ileum |
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Celiac Disease-sprue aka non tropical sprue?
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An immune – mediated disorder in genetically susceptible hosts (HLA genotype) with damage to SI mucosa & malabsorption.
Worldwide in distribution Occurs mostly in European whites Clinical onset anytime from infancy to late adulthood Abdominal pain, diarrhea, steatorrhea, dermatitis herpetiformis*, fatigue |
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Pathogenesis of Celiac Disease
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2 or more genes involved: class I HLA-B8 & class II HLA-DR3 & DQW2
Exposure to gliadin results in humoral & cell mediated injury Possible relationship to prior infection with adenovirus I2 E1B viral protein homologous with gliadin possibly resulting in cross reactivity Serum endomysial and tissue transglutaminase autoantibodies |
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Refractory Sprue-
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Absent or incomplete clinical response to gluten free diet
Abnormalities in T cells in many patients with loss of CD4 & CD8 & with monoclonal rearrangements in TCR gamma gene ? Early T cell lymphoma Some develop collagenous sprue |
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Giardiasis
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most common parasite in US
More comon in children infects via ingestion of water or food contaminated by cysts. Abrubt or gradual onset diarrhea More severe if underlying malnutrition or disease. Non invasive, provides mechanical blockade |
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Crohn's Disease
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An idiopathic chronic inflammatory disorder involving any part of the GIT
Worldwide distribution More common in western nations In US, incidence is rising; 8/100,000 Genetic susceptibility Most often presents in 2nd decade 2nd smaller peak in 8th decade |
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Gross Pathology of Crohn's Disease
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Thickened** wall with firm, stiff consistency due to fibrosis in submucosa, muscular hypertrophy & fat wrapping
Strictures- from thickened walls Fistulas- from fissures going all the way thru walls. In early or mild disease, mucosa has aphthous ulcers With progression, fissures or wide based longitudinal ulcers; cobblestone mucosa Skip areas** |
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Histopathology of Crohns Disease
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Transmural chronic inflammation with lymphoid nodules (string of beads)**
Fibrosis** Muscular & neuronal hypertrophy Basilar plasmacytosis PMNs in LP & epithelium (cryptitis) Ulcers, including fissures Pseudopyloric metaplasia Non-necrotizing granulomas** (biopsies 30%; resections 60%) Vasculitis Variability in changes |
