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©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 14, 2026; 32(2): 111996
Published online Jan 14, 2026. doi: 10.3748/wjg.v32.i2.111996
Published online Jan 14, 2026. doi: 10.3748/wjg.v32.i2.111996
Diagnostic clues in patients with clinical malabsorption and pathological small intestinal villous atrophy: Immune-mediated type and beyond
Mu-Han Li, Qi-Pu Wang, Cheng-Zhu Ou, Tian-Ming Xu, Yang Chen, Hao Tang, Ji Li, Jing-Nan Li, Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing 100730, China
Yan Zhang, Department of Haematology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing 100730, China
Yan-Jun Lai, Department of Gastroenterology, Zhangzhou Municipal Hospital of Fujian Province, Zhangzhou 363000, Fujian Province, China
Xu-Zhen Qin, Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing 100730, China
Wei-Xun Zhou, Department of Pathology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing 100730, China
Co-first authors: Mu-Han Li and Qi-Pu Wang.
Co-corresponding authors: Ji Li and Wei-Xun Zhou.
Author contributions: Li MH, Wang QP, and Ou CZ reviewed the literature and drafted the manuscript. Xu TM, Chen Y, Tang H, and Lai YJ verified the accuracy of the gastroenterological descriptions in this review. Zhou WX ensured the accuracy of the pathological information. Zhang Y and Qin XZ supplemented the draft and verified the accuracy of the descriptions related to other specialties, including hematology and laboratory medicine. Li JN, Zhou WX, and Li J contributed to outlining the manuscript, providing financial support, and refining the final version. All the authors read and approved the final manuscript. Li MH and Wang QP collaboratively conducted a comprehensive literature review and systematically organized the figures and tables. Li MH and Ou CZ jointly drafted the initial manuscript, integrating critical insights from other authors and revising the review accordingly. Wang QP critically reviewed the manuscript and performed language editing to enhance clarity and coherence. These authors have made crucial and indispensable contributions toward the completion of the review and thus qualify as co-first authors of the paper. As co-corresponding authors, Li J and Zhou WX defined the framework of this review and meticulously reviewed the manuscript to ensure the accuracy of its clinical content. Li J and Li JN provided essential financial support, contributed to manuscript revisions, and oversaw the finalization of the manuscript.
Supported by National High-Level Hospital Clinical Research Funding, No. 2022-PUMCH-B-022, and No. 2022-PUMCH-D-002; CAMS Innovation Fund for Medical Sciences, No. CIFMS 2021-1-I2M-003; and Undergraduate Innovation Program, No. 2024dcxm025.
Conflict-of-interest statement: Authors had nothing to disclose.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ji Li, MD, Professor, Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, No. 1 Shuaifuyuan Wangfujing, Dongcheng District, Beijing 100730, China.
Received: July 21, 2025
Revised: August 18, 2025
Accepted: December 2, 2025
Published online: January 14, 2026
Processing time: 175 Days and 20.9 Hours
Revised: August 18, 2025
Accepted: December 2, 2025
Published online: January 14, 2026
Processing time: 175 Days and 20.9 Hours
Core Tip
Core Tip: Small intestinal villous atrophy is a key pathological feature of various rare and heterogeneous disorders associated with malabsorption. Owing to overlapping clinical, serological, and histological features among immune-mediated, lym