Improving the Diagnosis of Dermatitis Herpetiformis Using the Intraepithelial Lymphogram

Dermatitis herpetiformis is a cutaneous manifestation of celiac disease. Phenotyping of intraepithelial lymphocytes in the small bowel mucosa can strengthen the diagnosis of celiac disease when it is not clear-cut. We aim to evaluate the usefulness of the intraepithelial lymphogram to confirm dermat...

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Autores: Fernández-Bañares, Fernando, Crespo, Laura, Planella de Rubinat, Montse, Farrais, Sergio, Izquierdo, Sandra, López-Palacios, Natalia, Roy, Garbiñe, Vidal, Judith, Núñez, Concepción
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Institución:Universitat de Lleida (UdL)
Repositorio:Repositori Obert UdL
OAI Identifier:oai:repositori.udl.cat:10459.1/465757
Acceso en línea:https://doi.org/10.3390/nu16020232
https://hdl.handle.net/10459.1/465757
Access Level:acceso abierto
Palabra clave:T-cell flow cytometry
TCRγδ+ cells
Celiac disease
Celiac intraepithelial lymphogram
Dermatitis herpetiformis
Gluten-free diet
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spelling Improving the Diagnosis of Dermatitis Herpetiformis Using the Intraepithelial LymphogramFernández-Bañares, FernandoCrespo, LauraPlanella de Rubinat, MontseFarrais, SergioIzquierdo, SandraLópez-Palacios, NataliaRoy, GarbiñeVidal, JudithNúñez, ConcepciónT-cell flow cytometryTCRγδ+ cellsCeliac diseaseCeliac intraepithelial lymphogramDermatitis herpetiformisGluten-free dietDermatitis herpetiformis is a cutaneous manifestation of celiac disease. Phenotyping of intraepithelial lymphocytes in the small bowel mucosa can strengthen the diagnosis of celiac disease when it is not clear-cut. We aim to evaluate the usefulness of the intraepithelial lymphogram to confirm dermatitis herpetiformis in equivocal cases. We performed a retrospective multicenter study on patients diagnosed with dermatitis herpetiformis and collected data from the intraepithelial lymphogram assessed by flow cytometry. A total of 36 patients were analyzed in relation to the severity of intestinal damage (18 had non-atrophic mucosa) at baseline (N = 28) and/or after the adoption of a gluten-free diet (median follow-up of three years, N = 16). We observed that patients with atrophy more often had positive celiac serology (p = 0.019), celiac clinical symptoms (p = 0.018), and iron-deficiency anemia (p = 0.018), but the severity of skin damage was similar in both groups (p = 0.79). At baseline, increased TCRγδ+ cells were present in 94% of patients with atrophy and 67% with non-atrophic lesions (p = 0.13). After a gluten-free diet, increased TCRγδ+ cells persisted in 100% and 63% of cases, respectively (p = 0.21). We concluded that increased TCRγδ+ cells may be helpful in confirming the diagnosis of dermatitis herpetiformis in equivocal cases, even in patients who were started on a gluten-free diet.MDPI2024info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://doi.org/10.3390/nu16020232https://hdl.handle.net/10459.1/465757reponame:Repositori Obert UdL instname:Universitat de Lleida (UdL)InglésReproducció del document publicat a: https://doi.org/10.3390/nu16020232Nutrients, 2024, vol. 16, núm. 2cc-by (c) authors, 2023Attribution 4.0 Internationalinfo:eu-repo/semantics/openAccesshttp://creativecommons.org/licenses/by/4.0/oai:repositori.udl.cat:10459.1/4657572026-06-24T12:42:17Z
dc.title.none.fl_str_mv Improving the Diagnosis of Dermatitis Herpetiformis Using the Intraepithelial Lymphogram
title Improving the Diagnosis of Dermatitis Herpetiformis Using the Intraepithelial Lymphogram
spellingShingle Improving the Diagnosis of Dermatitis Herpetiformis Using the Intraepithelial Lymphogram
Fernández-Bañares, Fernando
T-cell flow cytometry
TCRγδ+ cells
Celiac disease
Celiac intraepithelial lymphogram
Dermatitis herpetiformis
Gluten-free diet
title_short Improving the Diagnosis of Dermatitis Herpetiformis Using the Intraepithelial Lymphogram
title_full Improving the Diagnosis of Dermatitis Herpetiformis Using the Intraepithelial Lymphogram
title_fullStr Improving the Diagnosis of Dermatitis Herpetiformis Using the Intraepithelial Lymphogram
title_full_unstemmed Improving the Diagnosis of Dermatitis Herpetiformis Using the Intraepithelial Lymphogram
title_sort Improving the Diagnosis of Dermatitis Herpetiformis Using the Intraepithelial Lymphogram
dc.creator.none.fl_str_mv Fernández-Bañares, Fernando
Crespo, Laura
Planella de Rubinat, Montse
Farrais, Sergio
Izquierdo, Sandra
López-Palacios, Natalia
Roy, Garbiñe
Vidal, Judith
Núñez, Concepción
author Fernández-Bañares, Fernando
author_facet Fernández-Bañares, Fernando
Crespo, Laura
Planella de Rubinat, Montse
Farrais, Sergio
Izquierdo, Sandra
López-Palacios, Natalia
Roy, Garbiñe
Vidal, Judith
Núñez, Concepción
author_role author
author2 Crespo, Laura
Planella de Rubinat, Montse
Farrais, Sergio
Izquierdo, Sandra
López-Palacios, Natalia
Roy, Garbiñe
Vidal, Judith
Núñez, Concepción
author2_role author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv T-cell flow cytometry
TCRγδ+ cells
Celiac disease
Celiac intraepithelial lymphogram
Dermatitis herpetiformis
Gluten-free diet
topic T-cell flow cytometry
TCRγδ+ cells
Celiac disease
Celiac intraepithelial lymphogram
Dermatitis herpetiformis
Gluten-free diet
description Dermatitis herpetiformis is a cutaneous manifestation of celiac disease. Phenotyping of intraepithelial lymphocytes in the small bowel mucosa can strengthen the diagnosis of celiac disease when it is not clear-cut. We aim to evaluate the usefulness of the intraepithelial lymphogram to confirm dermatitis herpetiformis in equivocal cases. We performed a retrospective multicenter study on patients diagnosed with dermatitis herpetiformis and collected data from the intraepithelial lymphogram assessed by flow cytometry. A total of 36 patients were analyzed in relation to the severity of intestinal damage (18 had non-atrophic mucosa) at baseline (N = 28) and/or after the adoption of a gluten-free diet (median follow-up of three years, N = 16). We observed that patients with atrophy more often had positive celiac serology (p = 0.019), celiac clinical symptoms (p = 0.018), and iron-deficiency anemia (p = 0.018), but the severity of skin damage was similar in both groups (p = 0.79). At baseline, increased TCRγδ+ cells were present in 94% of patients with atrophy and 67% with non-atrophic lesions (p = 0.13). After a gluten-free diet, increased TCRγδ+ cells persisted in 100% and 63% of cases, respectively (p = 0.21). We concluded that increased TCRγδ+ cells may be helpful in confirming the diagnosis of dermatitis herpetiformis in equivocal cases, even in patients who were started on a gluten-free diet.
publishDate 2024
dc.date.none.fl_str_mv 2024
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://doi.org/10.3390/nu16020232
https://hdl.handle.net/10459.1/465757
url https://doi.org/10.3390/nu16020232
https://hdl.handle.net/10459.1/465757
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.3390/nu16020232
Nutrients, 2024, vol. 16, núm. 2
dc.rights.none.fl_str_mv cc-by (c) authors, 2023
Attribution 4.0 International
info:eu-repo/semantics/openAccess
http://creativecommons.org/licenses/by/4.0/
rights_invalid_str_mv cc-by (c) authors, 2023
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv MDPI
publisher.none.fl_str_mv MDPI
dc.source.none.fl_str_mv reponame:Repositori Obert UdL
instname:Universitat de Lleida (UdL)
instname_str Universitat de Lleida (UdL)
reponame_str Repositori Obert UdL
collection Repositori Obert UdL
repository.name.fl_str_mv
repository.mail.fl_str_mv
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