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Vajihinejad, M., Sadri, M., Eslami, S. (2025). Histopathological Spectrum of Duodenal Biopsies in Seropositive Pediatric Celiac Disease: A Retrospective Study from Yazd, Iran. Shahid Sadoughi University of Medical Sciences- Journal Management System, (), -.
Maryam Vajihinejad; Monireh Sadri; Saadat Eslami. "Histopathological Spectrum of Duodenal Biopsies in Seropositive Pediatric Celiac Disease: A Retrospective Study from Yazd, Iran". Shahid Sadoughi University of Medical Sciences- Journal Management System, , , 2025, -.
Vajihinejad, M., Sadri, M., Eslami, S. (2025). 'Histopathological Spectrum of Duodenal Biopsies in Seropositive Pediatric Celiac Disease: A Retrospective Study from Yazd, Iran', Shahid Sadoughi University of Medical Sciences- Journal Management System, (), pp. -.
Vajihinejad, M., Sadri, M., Eslami, S. Histopathological Spectrum of Duodenal Biopsies in Seropositive Pediatric Celiac Disease: A Retrospective Study from Yazd, Iran. Shahid Sadoughi University of Medical Sciences- Journal Management System, 2025; (): -.

Histopathological Spectrum of Duodenal Biopsies in Seropositive Pediatric Celiac Disease: A Retrospective Study from Yazd, Iran

World Journal of Peri & Neonatology
Articles in Press, Accepted Manuscript, Available Online from 11 November 2025
Document Type: Original Article
Authors
Maryam Vajihinejad; Monireh Sadri; Saadat Eslami*
Department of pathology, school of medicine, Shahid sadoughi hospital, Shahid Sadoughi University of medical sciences, Yazd, Iran
Abstract
Background: Celiac disease (CD) is an immune-mediated enteropathy triggered by gluten, with a global prevalence of approximately 1%. It is strongly associated with HLA-DQ2 and HLA-DQ8 haplotypes. Serological markers, particularly anti-tissue transglutaminase (tTG) immunoglobulin A (IgA), play a pivotal role in screening and diagnosis. This study aimed to evaluate the clinicopathological characteristics of duodenal biopsy specimens from patients with elevated serum tTG IgA levels.
Methods: This retrospective cross-sectional study analyzed 213 pediatric patients (age ≤16 years) with elevated anti-tTG IgA levels who underwent duodenal biopsy at Shahid Sadoughi Hospital, Iran (2016-2020). Demographic, clinical, and histopathological data were collected from medical records. Duodenal biopsies were classified using the Marsh-Oberhuber system. Statistical analysis was performed using SPSS version 22.
Results: The cohort consisted of 131 females (61.5%) and 82 males (38.5%), with a mean age of 5.9 years. The most common clinical manifestations were abdominal pain (58.7%) and failure to thrive (39%). Histopathological analysis revealed Marsh 3 lesions in 77% of cases (3a: 25.8%, 3b: 39.9%, 3c: 11.3%), while mild changes (Marsh 1-2) were observed in 23%. No significant association was found between Marsh classification and gender (p=0.36).
Conclusion: Elevated anti-tTG IgA levels strongly predict severe mucosal damage in pediatric celiac disease, suggesting the potential for reducing invasive biopsies through serology-based diagnosis. Validated antibody thresholds could enable less invasive diagnostic approaches.
Keywords
Celiac disease; anti-tTG IgA; Marsh classification; duodenal biopsy; pediatrics; histopathology
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