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The current approach to histological diagnosis of celiac disease (CD) is via duodenal biopsy. However, the number and location of biopsy samples are variable in practice. To examine that variation and possible associated factors, investigators retrospectively reviewed records of almost 6000 patients in two community hospitals who underwent duodenal biopsy for possible CD. Pathologic results were sorted into three categories: no CD (normal villi), possible CD (Marsh score <3); and CD (Marsh score =3). Forty-one patients (0.7%) were diagnosed with CD and 62 (1%) were diagnosed with possible CD.
The likelihood of diagnosing CD increased with the number of samples — for example, 0.4% in patients with <6 samples compared with 13% of patients with…