The Usefulness of Intraepithelial Lymphocyte Immunophenotype Testing for the Diagnosis of Coeliac Disease in Clinical Practice

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 diagnosi...

Descripción completa

Detalles Bibliográficos
Autores: Gutiérrez-Rios, Laura|||0000-0002-8638-6148, Calafat, Margalida|||0000-0003-2335-3792, Pascual, Irene, Roig Ramos, Cristina|||0000-0002-1723-1054, Teniente Serra, Aina|||0000-0003-3440-804X, Vergés, Laia, González Muñoza, Carlos|||0000-0003-0164-3449, Vayreda, Eva|||0000-0002-7738-2428, Vázquez, Diego, Gordillo, Jordi|||0000-0001-6418-0715, Mañosa i Ciria, Míriam|||0000-0002-9051-2581, Ramírez, Consuelo, García-Planella, Esther|||0000-0002-4325-0697, Planella, Montserrat, Domènech, Eugeni|||0000-0002-2315-7196
Tipo de recurso: artículo
Fecha de publicación:2024
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:306943
Acceso en línea:https://ddd.uab.cat/record/306943
https://dx.doi.org/urn:doi:10.3390/nu16111633
Access Level:acceso abierto
Palabra clave:Coeliac disease
Gluten-free diet
Immunophenotype
Intraepithelial lymphocytes
Descripción
Sumario: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.

Similares en LA Referencia