The Usefulness of Intraepithelial Lymphocyte Immunophenotype Testing for the Diagnosis of Coeliac Disease in Clinical Practice.
Nutrients
; 16(11)2024 May 26.
Article
in En
| MEDLINE
| ID: mdl-38892566
ABSTRACT
BACKGROUND:
The diagnosis of coeliac disease (CD) in adults is based on clinical, serological and histological criteria. The inappropriate performance of intestinal biopsies, non-specificity of mild histological lesions and initiation of a gluten-free diet (GFD) before biopsy may hamper the diagnosis. In these situations, determining the intraepithelial lymphogram of the duodenum by flow cytometry (IEL-FC) can be helpful.OBJECTIVES:
To describe the clinical scenarios in which the IEL-FC is used and its impact on the diagnosis of CD.METHODS:
All adult patients with suspected CD at three tertiary centres for whom the duodenal histology and IEL-FC were available were identified. Catassi and Fasano's diagnostic criteria and changes to a CD diagnosis after the IEL-FCs were collected.RESULTS:
A total of 348 patients were included. The following indications for an IEL-FC formed part of the initial study for CD (38%) negative conventional work-up (32%), already on a GFD before duodenal biopsies (29%) and refractoriness to a GFD (2%). The IEL-FC facilitated a definitive diagnosis in 93% of patients with an uncertain diagnosis who had had a conventional work-up for CD or who were on a GFD before histology.CONCLUSIONS:
The IEL-FC facilitates the confirmation or rejection of a diagnosis of CD in clinical scenarios in which a conventional work-up may be insufficient.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Celiac Disease
/
Immunophenotyping
/
Duodenum
/
Flow Cytometry
/
Intraepithelial Lymphocytes
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Nutrients
Year:
2024
Document type:
Article
Affiliation country:
Spain