Peculiar histopathological features of giardiasis in distal duodenal biopsies

ABSTRACT

Histological changes in 20 Giardia positive duodenal biopsies [Group A] were compared with 50, Giardia negative duodenal biopsies [Group B], taken during the same period. Stool examinations in Group B were negative for Giardia. Surface epithelium, villous and crypt architecture and cellular infiltrates were examined and compared between the groups. Atrophic changes in the villi were more common in Group A as compared to B [P<0.0001]. Intraepithelial neutrophil infiltration [P<0.001], infiltration of the lamina propria with plasma cells [P<0.5], and presence of eosinophils in the lamina propria [P<0.001] were significant findings in group A. Some of the changes were related to the density of Giardia colonization e.g., the goblet cell depletion [P<0.05] and the density of plasma cell infiltration in lamina propria [P<0.01]. Erosions and ulcerations were less commonly seen in group A. Thus we conclude that giardiasis manifests its peculiar features in the distal duodenal mucosa and a biopsy of this region is an important diagnostic tool for detection of this disease