Duodenal villous atrophy · histology

Villous atrophy is reduced intestinal villous height, sometimes progressing to complete flattening.

Review well-oriented fragments and establish their site; assess villi, crypts and intraepithelial lymphocytes.

Describe partial or marked atrophy, crypt hyperplasia and increased lymphocytes; poor orientation can mislead.

Coeliac disease is a major cause, but medicines, infections and other enteropathies can produce atrophy.

Atrophy is not specific; serology, immune status and exposures help distinguish enteropathies.

Correlate tissue-transglutaminase IgA, total IgA, symptoms and gluten exposure.

Histological stage describes mucosa; it is not an isolated measure of nutritional impact.

A gluten-free diet may alter serology and histology; interpretation therefore depends on dietary context.

Describe all three components and technical quality, then confirm the cause with clinical and serological evidence.

• European Society for the Study of Coeliac Disease (ESsCD) guideline for coeliac disease and other gluten-related disorders - PMC ↗
• Diagnosis and monitoring of celiac disease: changing utility of serology and histologic measures - American Gastroenterological Association ↗

Documentary review: 2026-10-15