Surgical Pathology Criteria

Celiac Disease

Modified Marsh Classification of histologic findings in celiac disease (Oberhuber)

Marsh Type IEL / 100 enterocytes – jejunum IEL / 100 enterocytes - duodenum Crypt hyperplasia Villi
0 <40 <30 Normal Normal
1 >40 >30 Normal Normal
2 >40 >30 Increased Normal
3a >40 >30 Increased Mild atrophy
3b >40 >30 Increased Marked atrophy
3c >40 >30 Increased Complete atrophy

Simplified systems may be more reproducible (Corazza, Roberts, Ensari)

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