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Marsh Stage of Celiac Disease


Updated October 07, 2009

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Marsh Score for Celiac Disease, Stage 4
Marsh Stage of Celiac Disease

This photomicrograph from a biopsy sample shows an intestinal lining that's been severely damaged by gluten.

© 2009 Ludvigsson et al.
In celiac disease Marsh score Stage 4, the villi are totally atrophied (completely flattened) and the crypts are now shrunken, too.


This photomicrograph is from Figure 1d of Ludvigsson et al. BMC Gastroenterology 2009 9:19. doi:10.1186/1471-230X-9-19. The photomicrographs were obtained from Prof. Åke Öst, earlier chairman of the Swedish National Steering Group for Small Intestinal Pathology.


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.

Snyder CL, Young DO, Green PHR, Taylor AK. GeneReviews: Celiac Disease. 2009

Hill ID, Dirks MH, Liptak GS, et al. Guideline for the diagnosis and treatment of celiac disease in children: recommendations of the North American Society fo Pediatric Gastroenterology, Hepatology and Nutrition. Journal of Pediatric Gastroenterology and Nutrition 2005;40:1-19.

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