PMC4518556_01
Autoimmune enteritis with duodenal biopsies prior to treatment:. A). Biopsies reveal severe villous atrophy and blunting, apoptosis, and marked epithelial damage. (hematoxylin and eosin, 4X [A] and 20X [B]). The red arrow indicates a crypt, and the yellow arrow points to the villous-crypt junction, highlighting the lack of villi.. C). Confirmatory staining of the duodenum shows lack of prominent intraepithelial lymphocytosis. (CD3 staining, 20X [C])
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F1
Biopsies from the duodenum showed complete villous atrophy and blunting, apoptosis, some neutrophilic cryptitis, and absence of intraepithelial lymphocytes with a confirmatory CD3 immunostain showing absence of T-cells (Figure 1).
Autoimmune enteritis with duodenal biopsies after 6 months of treatment with abatacept:. A-B). Subsequent biopsies show marked improvement in duodenal mucosa with regenerative epithelial changes and slightly blunted villous architecture. Overall, there is significant improvement and the degree of immune cell mediated effects is much less when compared to prior. (hematoxylin and eosin, 4X [A] and 20X [B]).
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F2
Overall, the degree of change was quite significant and much less involved compared to prior biopsy specimens (Figure 2).