Staging
Modified Marsh-Oberhuber classification
The modified Marsh-Oberhuber classification grades celiac-related intestinal biopsy changes from preserved villous architecture to villous atrophy.
Stages
- 0
Normal
Normal villous architecture without increased intraepithelial lymphocytes.
- I
Infiltrative
Increased intraepithelial lymphocytes with preserved villous architecture.
- II
Hyperplastic
Increased intraepithelial lymphocytes and crypt hyperplasia with preserved villous architecture.
- IIIa
Partial villous atrophy
Increased intraepithelial lymphocytes and crypt hyperplasia with partial villous atrophy.
- IIIb
Subtotal villous atrophy
Increased intraepithelial lymphocytes and crypt hyperplasia with subtotal villous atrophy.
- IIIc
Total villous atrophy
Increased intraepithelial lymphocytes and crypt hyperplasia with total villous atrophy.
- IV
Hypoplastic
Total villous atrophy with crypt hypoplasia.
Judged onSmall-intestinal mucosal histology, including intraepithelial lymphocytes, crypt changes, and villous architecture.
This histologic system describes the pattern of small-intestinal mucosal injury in celiac disease. Early categories retain villous architecture, while later categories record crypt hyperplasia and increasing degrees of villous atrophy. It is used to report biopsy findings, not to describe symptoms or the clinical severity of a patient. The Oberhuber modification subdivides the villous-atrophy category and includes a hypoplastic pattern.
Learn it in
- Diagnosing Celiac Disease in ChildrenPediatrics