Endoscopy 2010; 42(3): 191-196
DOI: 10.1055/s-0029-1243838
Original article

© Georg Thieme Verlag KG Stuttgart · New York

In vivo real-time imaging of human duodenal mucosal structures in celiac disease using endocytoscopy

T.  Matysiak-Budnik1 , E.  Coron1 , J.-F.  Mosnier2 , M.  Le Rhun1 , H.  Inoue3 , J.-P.  Galmiche1
  • 1Institut des Maladies de l’Appareil Digestif – INSERM U913, CIC 04 et Service d’Hépato-Gastroentérologie, Hôtel Dieu, CHU de Nantes, France
  • 2Service d’Anatomie Pathologique, E.A. Biometadys, CHU de Nantes, France,
  • 3Digestive Disease Center, Showa University Northern Yokohama Hospital, Japan
Further Information

Publication History

submitted 26 May 2009

accepted after revision 18 October 2009

Publication Date:
25 January 2010 (online)

Background and aims: Celiac disease is a gluten-induced enteropathy whose diagnosis is based on histological evidence of villous atrophy. The diagnosis may be difficult if the orientation of histological sections is other than optimal. During upper gastrointestinal endoscopy we studied in vivo duodenal mucosa in patients with celiac disease using endocytoscopy, a novel diagnostic technique allowing in vivo real-time visualization of mucosa under × 450 magnification.

Methods: Sixteen patients with documented celiac disease and seven controls without celiac disease were studied. Endocytoscopic images obtained from several fields were compared in a blinded fashion to standard histology.

Results: Endocytoscopy showed three different patterns of in vivo histology: (1) the presence of normal-appearing, long, thin villi, lined with clearly distinguishable surface epithelial cells, considered to be normal duodenal mucosa (n = 15, all controls and eight celiac disease patients); (2) the presence of thick, shortened villi, reflecting partial villous atrophy (n = 4); and (3) the total absence of villi and the presence of enlarged crypt orifices, reflecting total villous atrophy (n = 4). Good concordance between endocytoscopy and standard histology was found in all 16 patients with celiac disease.

Conclusions: Endocytoscopy allows in vivo, real-time, noninvasive visualization and characterization of villous architecture and may be a promising method for in vivo evaluation of duodenal mucosa in celiac disease.

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T. Matysiak-BudnikMD PhD 

IMAD & INSERM U913, CIC 04
Service d’Hépato-Gastroentérologie
Hôtel Dieu
CHU de Nantes

1 Place Alexis Ricordeau
44093 Nantes
France

Fax: +33-2-40083168

Email: tamara.matysiakbudnik@chu-nantes.fr