The following is a summary of “Spectrum of Duodenal Histologic Findings in Patients With Trisomy 21: A Multicenter Study,” published in the August 2023 issue of Pediatrics by Alexander, et al.

For a retrospective cohort study, researchers sought to characterize duodenal histological abnormalities in Trisomy 21 (T21) patients who underwent esophagogastroduodenoscopy (EGD). A secondary aim was to explore the associations of histologic findings with different therapies.

The study included patients with T21 aged 30 years or younger who underwent EGD at 6 hospitals between 2000 and 2020. Duodenal biopsies were categorized as normal or abnormal based on reported histopathology findings. Abnormal pathology reports were further classified into villous atrophy (VA) and duodenitis without VA. The VA group was then subdivided based on the presence or absence of celiac disease (CD).

A total of 836 patients with T21 who underwent EGD were identified, and 419 (50.1%) of them had duodenal histologic abnormalities. Among those with abnormal biopsies, 290 had VA at the time of the first (index) biopsy. Of the 290 patients with VA, 172 met the diagnostic criteria for CD, while 118 did not meet CD criteria and were classified as having nonspecific VA. Acid suppression therapy was less common in patients with VA-CD than patients without VA or those with nonspecific VA at the time of the index biopsy (12.2% vs. 45.7% vs. 44.9%, respectively).

In the cohort of patients with T21, half had abnormal duodenal biopsies, with a subgroup showing nonspecific villous atrophy. Acid suppression therapy was more prevalent in patients with abnormalities other than CD.

Source: journals.lww.com/jpgn/Abstract/2023/08000/The_Spectrum_of_Duodenal_Histologic_Findings_in.10.aspx