Endoscopic Duodenal Biopsy Compared with Biopsy with the Watson Capsule from the Upper Jejunum in Patients with Dermatitis Herpetiformis

Abstract
Patients (48) with dermatitis herpetiformis were investigated with duodenoscopy, endoscopic biopsy and conventional upper jejunal biopsy. Three endoscopic biopsy specimens were obtained from the duodenal bulb, 3-6 specimens from the 2nd part of the duodenum and 1 suction biopsy from the upper jejunum. In 60, 71 and 65% of the patients, subtotal or partial villous atrophy was found in biopsies from the 3 levels, respectively. In 8 patients (17%) mucosal abnormalities were confined to the duodenal biopsies and in 2 patients to the jejunal biopsies. The technique of endoscopic biopsy is advocated because multiple visually selected duodenal specimens may be obtained and because this technique also enables a complete evaluation of the stomach.