Marsh classification

Marsh classification

A system used to grade the histologic severity of coeliac disease based on assessment of duodenal biopsies, which show blunting of villi and the intraepithelial lymphocyte-to-enterocyte ratio.
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Marsh classification will be discussed in detail in association with other classification schemes in the following sections.
Marsh classification is composed of 4 consecutive states of mucosal damage (types 1-4) as follows.
One problem arising from Marsh classification is that the cutoff for the number of IELs has not been defined.
Although the Marsh classification, as modified by Oberhuber et al, (59) is used by many pathologists, both for diagnosis and also to assess the response to therapy, this classification has the potential to cause significant reproducibility problems leading to increased intraobserver and interobserver variations because of the greater number of diagnostic categories.
At this point, I would like to propose an updated version of the original Marsh classification, which, from a pathologist's point of view, is much simpler and user-friendly.
Morphology was categorized according to the modified Marsh classification (1, 22).
Table 2 also shows the histological characteristics of small-bowel biopsies according to the modified Marsh classification.
2] Clinical categorization of CD Classic 51 Subclinical 9 Asymptomatic 0 Marsh classification, n Type 0 0 80 Type I 0 Type II 0 Type IIIa 2 1 (b) Type IIIb 9 Type IIIc 49 Mean IELs/100 epithelial 40.