Table 1.
Type 0 |
Pre-infiltrative: normal V:C ratio and crypts with < 20-25 IELs per 100 enterocytes (1:5 or 1:4) |
Type 1 |
Infiltrative type: normal V:C ratio and crypts, but ↑ IELs (≥ 20-25 IELs/100 enterocytes) |
Type 2 |
Infiltrative-hyperplastic type: normal V:C ratio, but crypt hyperplasia with ↑ IELs |
Type 3 |
Destructive (flat mucosa) type of GSE lesion according to the degree of villous atrophy |
Type 3a: mild villous atrophy with V: C < 3:1, and ↑ IELs |
Type 3b: marked villous atrophy with V: C < 1:1, and ↑ IELs |
Type 3c: total villous atrophy with completely flat mucosa and ↑ IELs |
Type 4 |
Atrophic type (hypoplastic); flat mucosa with only a few crypts and near-normal IEL count |
V:C: Villous to crypt ratio (normal, V:C > 3:1); GSE: Gluten-sensitive enteropathy; IEL: Intraepithelial lymphocytes. The upper limit of IEL may be considered 20 or 25 according to the country, institution, and physician’s preference, although mostly 25 seems to be the most accepted current threshold.