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Cited by 49Celiac Disease Research and ManagementEosinophilic EsophagitisWheat and Barley Genetics and Pathology

Intestinal Intraepithelial Lymphocyte Cytometric Pattern Is More Accurate than Subepithelial Deposits of Anti-Tissue Transglutaminase IgA for the Diagnosis of Celiac Disease in Lymphocytic Enteritis

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Fernández-Bañares, Fernando, Carrasco, Anna, García-Puig, Roger, Rosinach, Mercè, González, Clarisa, Alsina, Montserrat, Loras, Carme, Salas, Antonio +2 more·2014·PLoS ONE
DOI 10.1371/journal.pone.0101249PMC PMC4091865
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Abstract

BACKGROUND & AIMS: An increase in CD3+TCRγδ+ and a decrease in CD3- intraepithelial lymphocytes (IEL) is a characteristic flow cytometric pattern of celiac disease (CD) with atrophy. The aim was to evaluate the usefulness of both CD IEL cytometric pattern and anti-TG2 IgA subepithelial deposit analysis (CD IF pattern) for diagnosing lymphocytic enteritis due to CD. METHODS: Two-hundred and five patients (144 females) who underwent duodenal biopsy for clinical suspicion of CD and positive celiac genetics were prospectively included. Fifty had villous atrophy, 70 lymphocytic enteritis, and 85 normal histology. Eight patients with non-celiac atrophy and 15 with lymphocytic enteritis secondary to Helicobacter pylori acted as control group. Duodenal biopsies were obtained to assess both CD IEL flow cytometric (complete or incomplete) and IF patterns. RESULTS: Sensitivity of IF, and complete and incomplete cytometric patterns for CD diagnosis in patients with positive serology (Marsh 1+3) was 92%, 85 and 97% respectively, but only the complete cytometric pattern had 100% specificity. Twelve seropositive and 8 seronegative Marsh 1 patients had a CD diagnosis at inclusion or after gluten free-diet, respectively. CD cytometric pattern showed a better diagnostic performance than both IF pattern and serology for CD diagnosis in lymphocytic enteritis at baseline (95% vs 60% vs 60%, p = 0.039). CONCLUSIONS: Analysis of the IEL flow cytometric pattern is a fast, accurate method for identifying CD in the initial diagnostic biopsy of patients presenting with lymphocytic enteritis, even in seronegative patients, and seems to be better than anti-TG2 intestinal deposits.

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  • The diagnostic efficacy of the assessment of iIELs by flow cytometry has been confirmed for the differentiation of active celiac disease patients, celiac disease in remission and subclinical or potential celiac disease in both pediatric and adult patients.

    “The diagnostic efficacy of the assessment of iIELs by flow cytometry has been confirmed for the differentiation of active celiac disease patients, Celiac disease in remission and subclinical or potential celiac disease in both pediatric and adult patients [315-318]”

    From Guidelines for the use of flow cytometry and cell sorting in immunological studies (third edition) (2021) · cites this paper as [316]

    The Discussion (page not specified) reports high diagnostic accuracy for the flow-cytometric IEL pattern in patients with villous atrophy and positive celiac serology. The Results, ‘Patients with normal histology’ (page not specified), also report a distinct IEL finding in patients considered to have latent celiac disease. The paper does not establish that the test differentiates active disease from remission, or demonstrate diagnostic efficacy separately in pediatric and adult patients. (LLM, conf=0.84)

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  1. [31]Farré C (2002) Enfermedad celíaca: Marcadores serológicos y de predisposición genética, aspectos clínicos y poblaciones de riesgo. Doctoral Thesis. University of Barcelona.

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Authors
Fernández-Bañares, F., Carrasco, A., García-Puig, R., Rosinach, M., González, C., Alsina, M., Loras, C., Salas, A., Viver, J. M., & Esteve, M.
Affiliations
University Hospital Mútua de Terrassa (ES)
ORCID
Venue
PLoS ONE
Publisher
Public Library of Science (PLoS)
Published
2014-07-10
Volume
9
Issue
7
Pages
e101249
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0101249
PMC
PMC4091865
OpenAlex
W2037179981
Cited by
49
References
42
Citations by year
2026: 2 · 2025: 1 · 2024: 4 · 2023: 3 · 2022: 1 · 2021: 10 · 2020: 4 · 2019: 7 · 2018: 1 · 2017: 2 · 2016: 4 · 2015: 9 · 2014: 1
FWCI
5.35
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Dipòsit Digital de la Universitat de Barcelona (Universitat de Barcelona) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Figshare (submittedVersion, cc-by)
Funders
  • Universitat de Barcelona
  • Universitat Autònoma de Barcelona
  • Instituto de Salud Carlos III
Topics
  • Health Sciences › Medicine › Gastroenterology › Celiac Disease Research and Management
  • Health Sciences › Medicine › Surgery › Eosinophilic Esophagitis
  • Life Sciences › Agricultural and Biological Sciences › Plant Science › Wheat and Barley Genetics and Pathology
Keywords
celiac disease, intraepithelial lymphocytes, anti-tissue transglutaminase IgA, subepithelial deposits, immunofluorescence patterns, villous atrophy, seronegative celiac disease, duodenal biopsy, diagnostic accuracy, TCR gamma delta T cells
MeSH terms
Protein Glutamine gamma Glutamyltransferase 2, Adolescent, Adult, Aged, Celiac Disease, Child, Child, Preschool, Enteritis, Female, Flow Cytometry, Humans, Immunoglobulin A, Infant, Intestinal Mucosa, Lymphocytes, Male, Middle Aged, Prospective Studies, Transglutaminases, Sensitivity and Specificity, Serologic Tests, GTP-Binding Proteins, Young Adult

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