The Usefulness of Intraepithelial Lymphocyte Immunophenotype Testing for the Diagnosis of Coeliac Disease in Clinical Practice
Gutiérrez-Rios, Laura (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Calafat, Margalida (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Pascual, Irene (Hospital Universitari Arnau de Vilanova)
Roig Ramos, Cristina (Institut de Recerca Sant Pau)
Teniente Serra, Aina (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Vergés, Laia (Hospital Universitari Arnau de Vilanova)
Gonzalez-Muñoza, Carlos (Institut de Recerca Sant Pau)
Vayreda, Eva (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Vázquez, Diego (Hospital Universitari Arnau de Vilanova)
Gordillo, Jordi (Institut de Recerca Sant Pau)
Mañosa i Ciria, Míriam (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Ramírez, Consuelo (Institut de Recerca Biomèdica de Lleida)
García-Planella, Esther (Institut de Recerca Sant Pau)
Planella, Montserrat (Institut de Recerca Biomèdica de Lleida)
Domènech, Eugeni (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Universitat Autònoma de Barcelona

Date:	2024
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.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Coeliac disease ; Gluten-free diet ; Immunophenotype ; Intraepithelial lymphocytes
Published in:	Nutrients, Vol. 16 Núm. 11 (26 2024) , ISSN 2072-6643

DOI: 10.3390/nu16111633
PMID: 38892566

9 p, 1.1 MB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
Articles > Published articles