The Usefulness of Intraepithelial Lymphocyte Immunophenotype Testing for the Diagnosis of Coeliac Disease in Clinical Practice
Por:
Gutiérrez-Rios, L, Calafat, M, Pascual, I, Roig, C, Teniente-Serra, A, Vergés, L, González-Muñoza, C, Vayreda, E, Vázquez, D, Gordillo, J, Mañosa, M, Ramírez, C, Garcia-Planella, E, Planella, M, Domènech, E
Publicada:
1 jun 2024
Resumen:
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.
Filiaciones:
Gutiérrez-Rios, L:
Hosp Univ Germans Trias i Pujol, Gastroenterol Dept, Badalona, Spain
Calafat, M:
Hosp Univ Germans Trias i Pujol, Gastroenterol Dept, Badalona, Spain
Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid 28029, Spain
Pascual, I:
Hosp Arnau Vilanova, Gastroenterol Hosp, Lleida 25198, Spain
Roig, C:
Hosp Santa Creu i St Pau, Gastroenterol Dept, Barcelona 08041, Spain
Teniente-Serra, A:
Hosp Univ Germans Trias i Pujol, Immunol Dept, Badalona 08029, Spain
Vergés, L:
Hosp Arnau Vilanova, Gastroenterol Hosp, Lleida 25198, Spain
González-Muñoza, C:
Hosp Santa Creu i St Pau, Gastroenterol Dept, Barcelona 08041, Spain
Vayreda, E:
Hosp Univ Germans Trias i Pujol, Gastroenterol Dept, Badalona, Spain
Vázquez, D:
Hosp Arnau Vilanova, Gastroenterol Hosp, Lleida 25198, Spain
Gordillo, J:
Hosp Santa Creu i St Pau, Gastroenterol Dept, Barcelona 08041, Spain
Mañosa, M:
Hosp Univ Germans Trias i Pujol, Gastroenterol Dept, Badalona, Spain
Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid 28029, Spain
Ramírez, C:
Hosp Arnau Vilanova, Gastroenterol Hosp, Lleida 25198, Spain
Digest Dis Res Grp DdRG IRBLleida, Lleida 25198, Spain
Garcia-Planella, E:
Hosp Santa Creu i St Pau, Gastroenterol Dept, Barcelona 08041, Spain
Planella, M:
Hosp Arnau Vilanova, Gastroenterol Hosp, Lleida 25198, Spain
Digest Dis Res Grp DdRG IRBLleida, Lleida 25198, Spain
Domènech, E:
Hosp Univ Germans Trias i Pujol, Gastroenterol Dept, Badalona, Spain
Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid 28029, Spain
Univ Autonoma Barcelona, Sch Med, Barcelona 08193, Spain
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