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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Taavela (19) reported that the Marsh classification "is often too imprecise (how often, and in what way, might we ask?) and ignores minor but significant changes in mucosa." Unfortunately, the "minor but significant changes" have not been highlighted.

The simplistic nature of the Marsh classification with two or three basic categories was unfortunately confused by the later attempts to standardize it (47).

Diagnosing celiac disease: A critical overview

Modified Marsh Classification was used to grade the histopathology of biopsy samples.

Investigation of celiac disease according to Marsh classification in childhood.

Spectrum of Celiac disease in Paediatric population: Experience of Tertiary Care Center from Pakistan

All the cases were classified according to the Marsh classification.

Is the Diagnosis of Celiac Disease Possible Without Intestinal Biopsy?

Variable Frequency Percentage Sex Female 49 60.5 Male 32 39.5 Diabetes Yes 20 24.7 No 61 75.3 Hypothyroidism Yes 10 12.3 No 71 87.7 Gastrointestinal symptoms Yes 38 46.9 No 43 53.1 Short stature Yes 38 46.9 No 43 53.1 Family history of celiac Yes 21 25.9 No 60 74.1 Histopathology changes Yes 66 81.5 No (silent) 15 18.5 Marsh grading of histopathology changes Marsh 0 15 18.5 Marsh I 3 3.7 Marsh II 14 17.3 Marsh III 49 60.5 tTG titer <180 30 37 [greater than or equal to] 180 51 63 TABLE 2: Marsh classification and anti-tTG titer cross tabulation.

Association of tissue transglutaminase antibody titer with duodenal histological changes in children with celiac disease

[27] found that the stage of duodenal mucosal injury (following Marsh classification) was the most important factor in determining low BMD at diagnosis but they considered differences between Marsh I, Marsh II, and Marsh III grades unlike our study design.

Bone mineral density at diagnosis of celiac disease and after 1 year of gluten-free diet

Categorizing cases of celiac disease using the Marsh classification yielded one case of class 0, 5 cases of class 2, 10 cases of class 3a, 19 cases of 3b, and 1 case of class 3c.

Utility of tissue transglutaminase immunohistochemistry in pediatric duodenal biopsies: patterns of expression and role in celiac disease--a clinicopathologic review

According to the modified Marsh classification, (5) the results were consistent with CD, type 3B (Figure 1).

Celiac disease presenting with vitamin D deficiency and low bone mineral density in the puerperium / lohusalik doneminde D vitamin eksikligi ve dusuk kemik mineral yogunlugu ile ortaya cikan Colyak hastaligi

Recently, Ensari has proposed an updated version of the time-honored Marsh classification, which is much simpler, and user-friendly from a pathologist\'s point of view.6 However, it needs to be validated in prospective studies in different centers of the world before it can get widespread acceptability.

Coeliac disease diagnosis: has histopathology become redundant?

Marsh classification will be discussed in detail in association with other classification schemes in the following sections.

Gluten-sensitive enteropathy (celiac disease) controversies in diagnosis and classification

Table 2 also shows the histological characteristics of small-bowel biopsies according to the modified Marsh classification. Only a minority of patients had mild histological changes (Marsh type II and IIIa); most patients showed severe villous atrophy (Marsh IIIb or IIIc).

Antibodies against synthetic deamidated gliadin peptides as predictors of celiac disease: prospective assessment in an adult population with a high pretest probability of disease

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