Home > E. Pathology by systems > Digestive system > Small intestine > intestinal villous atrophy
intestinal villous atrophy
Monday 15 December 2003
atrophic villi, flat villi
Synopsis
atrophic and flat intestinal villi
Types (according to extension)
focal villous atrophy
diffuse villous atrophy
Types (according to crypt appearance)
hyperplastic villous atrophy
hypoplastic villous atrophy (with crypt hyperplasia)
Types (according to inflammation)
villous atrophy with mucosal inflammation
villous atrophy without mucosal inflammation
Etiology
hyperplastic villous atrophy (with crypt hyperplasia)
- coeliac disease (gluten-senstive enteropathy)
- chronic trauma
- small bowell transplanted as an artificial oesopahgus
- urinary ileal conduits
- intestinal mucosal inflammation
- adjacent to intestinal ulcers
- intestinal anastomosis
- glucagonoma
- extensive small bowell resections
- primary ileal villous atrophy
hypoplastic villous atrophy (without crypt hyperplasia)
- malnutrition (kwashiorkor)
- malignancy
- untreated pernicious anemia
- Paneth cell deficiency
- hypopituitarism
- celiac disease unresponsive to gluten-free diet
- tropical sprue
- radiation-associated ischemia
- drug-induced villous atrophy
- neomycin
- azathioprin (12806628)
Variants
villous atrophy with mucosal inflammation (chorionic inflammation)
- celiac disease
- severe alimentary intolerance
- congenital Crohn disease
- autoimmune enteropathy
- various enterocolitis
- immunodeficiency syndromes
- selective IgA deficiency
Marsh classification of intestinal villous atrophy
| Types | Type 0 | Type 1 | Type 2 | Type 3a | Type 3b | Type 3c |
| IEL | @<@40 | >40 | >40 | >40 | >40 | >40 |
| Crypts | Normal | Normal | Hypertrophic | Hypertrophic | Hypertrophic | Hypertrophic |
| Villi | Normal | Normal | Normal | Mild atrophy | Marked atrophy | Absent |
NB: IEL, IntraEpithelial Lymphocytes (per 100 epithelial cells)
See also
villous anomalies
intestinal lesions
References
Ludvigsson JF, Brandt L, Montgomery SM, Granath F, Ekbom A. Validation study of villous atrophy and small intestinal inflammation in Swedish biopsy registers. BMC Gastroenterol. 2009;9:19.