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Coeliac disease is the most well\u2010known example, causing intraepithelial lymphocytosis, inflammation and villous atrophy in the duodenum. Remarkably similar inflammatory changes can be induced by other processes, including medications, e.g. angiotensin II receptor blockers and immune checkpoint inhibitors, immune dysregulation disorders, e.g. common variable immunodeficiency and autoimmune enteropathy, infections, collagenous sprue, and tropical sprue. However, there are often subtle histological differences from coeliac disease in the type of inflammatory infiltrate, the presence of crypt apoptosis, and the extent and type of inflammation beyond the duodenum. The clinical setting and serological investigation usually allow diagnostic separation, but some cases remain challenging. Histopathology is also important in assessing the response to treatment, such as the change in villous architecture caused by a gluten\u2010free diet, or the response to cessation of a potentially causative medication. This review examines the practical role that histopathology of duodenal biopsy specimens plays in the assessment and management of inflammatory malabsorptive processes of the proximal small intestine, with a particular emphasis on coeliac disease.<\/jats:p>","DOI":"10.1111\/his.14262","type":"journal-article","created":{"date-parts":[[2020,12,31]],"date-time":"2020-12-31T15:49:41Z","timestamp":1609429781000},"page":"88-105","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["The role of histopathology in the diagnosis and management of coeliac disease and other malabsorptive conditions"],"prefix":"10.1111","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6329-2547","authenticated-orcid":false,"given":"Ian","family":"Brown","sequence":"first","affiliation":[{"name":"Envoi Specialist Pathologists University of Queensland  Brisbane Queensland Australia"},{"name":"Faculty of Medicine University of Queensland  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0880-3049","authenticated-orcid":false,"given":"Mark","family":"Bettington","sequence":"additional","affiliation":[{"name":"Envoi Specialist Pathologists University of Queensland  Brisbane Queensland Australia"},{"name":"Faculty of Medicine University of Queensland  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7671-2651","authenticated-orcid":false,"given":"Christophe","family":"Rosty","sequence":"additional","affiliation":[{"name":"Envoi Specialist Pathologists University of Queensland  Brisbane Queensland Australia"},{"name":"Faculty of Medicine University of Queensland  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,12,31]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.giec.2016.08.001"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2017-315909"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.giec.2016.08.007"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.giec.2016.08.006"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2013.04.167"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2008.108"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0000000000001107"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2013.79"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2013-306578"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.2003.013607"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.55.5.393"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2017-314297"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/00365520310008773"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gtc.2018.09.004"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2017.06.037"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gtc.2018.09.007"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12373"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31796-8"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-019-1380-z"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.giec.2012.07.003"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1309\/AJCPE89ZPVJTSPWL"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e318254f413"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.33.9.1190"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2559.2006.02547.x"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005176-200004000-00009"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12519-010-0008-3"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2010.153"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2009.557"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2013.06.012"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-995361"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2007.10.015"},{"key":"e_1_2_8_33_1","doi-asserted-by":"crossref","first-page":"E1369","DOI":"10.1055\/a-0732-5060","article-title":"Efficacy of duodenal bulb biopsy for diagnosis of celiac disease: a systematic review and meta\u2010analysis","volume":"6","author":"McCarty TR","year":"2018","journal-title":"Endosc. 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