Frequency of Celiac Disease in Patients with Hypothyroidism

Table 1

Modified marsh classification of CD [11].

Marsh type	Intraepithelial Lymphocytes per 100 Enterocytes	Crypts	Villi
0	<40	Normal	Normal
1	>40	Normal	Normal
2	>40	Increased	Normal
3a	>40	Increased	Mild atrophy
3b	>40	Increased	Marked atrophy
3c	>40	Increased	Absent

Type 0: normal mucosa; CD highly unlikely.
Type 1 (Infiltrative lesion): seen in patients on a gluten-free diet (suggesting minimal amounts of gliadin are being ingested); patients with DH; and family members of patients with CD. However, these patients need to be followed because they may convert to a type 3 lesion.
Type 2 (hyperplastic type): very rare; seen occasionally in DH.
Type 3 (destructive lesion): spectrum of changes seen in symptomatic CD.