{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T22:28:53Z","timestamp":1787005733513,"version":"build-2736575974"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2009,9,1]],"date-time":"2009-09-01T00:00:00Z","timestamp":1251763200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. pediatr. gastroenterol. nutr."],"published-print":{"date-parts":[[2009,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective:<\/jats:title><jats:p>To determine the prevalence and type of histological abnormalities in duodenal mucosa associated with <jats:italic>Giardia lamblia<\/jats:italic> in children who undergo esophago\u2010gastroduodenoscopy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods:<\/jats:title><jats:p>Duodenal biopsies containing <jats:italic>G lamblia<\/jats:italic> were retrieved from all paediatric patients who had undergone endoscopy in our centre in the last 20 years. These biopsies were scored for histological abnormalities by a single pathologist using a semiquantative scale and staged according to the Marsh criteria. In those with a Marsh stage above 0, the presence of coeliac disease was investigated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>After excluding all patients with concomitant coeliac disease, 4 out of 32 (13%) patients had a biopsy showing crypt hyperplasia and 1 out of 32 (3%) had partial villous atrophy. No intraepithelial lymphocytosis was found. In our cohort, 2 patients with giardiasis and mild histological abnormalities were diagnosed with coeliac disease only after a repeated endoscopy and serology were performed; in 1 of them after a delay of 5 years. Other histological abnormalities frequently observed were increased eosinophilic infiltration of the lamina propria (35%) and lymph follicle formation (35%). Infiltration of neutrophilic and eosinophilic granulocytes in the epithelial layer was observed less frequently (16% and 9%, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p>Villous atrophy, intraepithelial lymphocytosis and\/or crypt hyperplasia are rare in children with giardiasis who undergo esophagogastroduodenoscopy. Therefore, other causes, particularly coeliac disease, should always be suspected. This study, however, suggests that giardiasis can cause chronic mucosal inflammation, often of an eosinophilic nature, in these children.<\/jats:p><\/jats:sec>","DOI":"10.1097\/mpg.0b013e31818de3c4","type":"journal-article","created":{"date-parts":[[2009,8,24]],"date-time":"2009-08-24T07:12:00Z","timestamp":1251097920000},"page":"304-308","source":"Crossref","is-referenced-by-count":44,"title":["Does <i>Giardia lamblia<\/i> Cause Villous Atrophy in Children?: A Retrospective Cohort Study of the Histological Abnormalities in Giardiasis"],"prefix":"10.1002","volume":"49","author":[{"given":"Bart GP","family":"Koot","sequence":"first","affiliation":[{"name":"Department of Pediatric Gastroenterology and Nutrition The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiebo JW","family":"ten Kate","sequence":"additional","affiliation":[{"name":"Department of Pathology Amsterdam Medical Centre Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Juffrie","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology and Hepatology Gadjah Mada University Yogyakarta Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ina","family":"Rosalina","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology and Hepatology Padjadjaran University Bandung Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan JAM","family":"Taminiau","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology and Nutrition The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc A","family":"Benninga","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology and Nutrition The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2009,9]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00001432-200310000-00012"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005176-199701000-00018"},{"key":"e_1_2_6_4_1","first-page":"408","article-title":"Quantification of the lymphocytic infiltrate in jejunal epithelium in giardiasis","volume":"29","author":"Wright SG","year":"1977","journal-title":"Clin Exp Immunol"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.18.5.343"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.24.2.120"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1086\/513745"},{"key":"e_1_2_6_8_1","first-page":"395","volume-title":"Gastrointestinal Pathology: An Atlas and Text","author":"Nonneoplastic lesions of the small intestine.","year":"1999"},{"key":"e_1_2_6_9_1","first-page":"283","volume-title":"Morson and Dawson's Gastrointestinal Pathology","author":"Inflammatory disorders of the small intestine.","year":"2003"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.45.242.466"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.1976.tb04929.x"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.1536-4801.1982.tb08381.x"},{"key":"e_1_2_6_13_1","first-page":"337","article-title":"Intestinal biopsies and giardiasis in pediatrics","volume":"29","author":"Sarrut S","year":"1982","journal-title":"Ann Pediatr (Paris)"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005176-198302030-00013"},{"key":"e_1_2_6_15_1","first-page":"818","article-title":"Giardiasis in childhood: poor clinical and histological correlations","volume":"19","author":"Judd R","year":"1983","journal-title":"Isr J Med Sci"},{"key":"e_1_2_6_16_1","first-page":"27","article-title":"A proposal for the classification of intestinal complications in giardiasis","volume":"16","author":"Fragoso T","year":"1986","journal-title":"Acta Gastroenterol Latinoam"},{"key":"e_1_2_6_17_1","first-page":"102","article-title":"Giardiasis. 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