A Scoring System for Identifying Patients Likely to Be Diagnosed with Low-Grade Coeliac Enteropathy
AbstractBackground & Aims: Determining whether patients with lymphocytic enteritis (LE) have coeliac disease is a challenge. We analysed the variables associated with a low-grade coeliac enteropathy diagnosis in patients with suspected coeliac disease but without villous atrophy, and developed a scoring system to identify them. Methods: We collected data from 2010 through to 2016 on patients with lymphocytic enteritis and persistent symptoms compatible with the clinical spectrum of coeliac disease. One hundred and four patients starting on a gluten-free diet (GFD) were included. Duodenal biopsies were collected before the GFD and analysed for numbers of CD3+ T-cell receptor gamma delta+ (TCRγδ+), and CD3− intraepithelial lymphocytes. We performed a logistic regression analysis to identify factors associated with a low-grade coeliac enteropathy diagnosis. Results: Sixty-two patients achieved clinical remission after the GFD. Fifty of these 62 patients were diagnosed with low-grade coeliac enteropathy. Multivariate analysis identified the presence of >25% intraepithelial lymphocytosis, HLA-DQ2.5, positive serology, and increased numbers of TCRγδ+ cells with a low-grade coeliac enteropathy diagnosis. We developed a scoring system that identified patients with an area under the ROC curve (AUC) of 0.91. Scores of >10 had 86% sensitivity and 85% specificity. Conclusion: We developed a scoring system that identifies patients likely to be diagnosed with low-grade coeliac enteropathy with an AUC value of 0.91. View Full-Text
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Fernández-Bañares, F.; Carrasco, A.; Rosinach, M.; Arau, B.; García-Puig, R.; González, C.; Tristán, E.; Zabana, Y.; Esteve, M. A Scoring System for Identifying Patients Likely to Be Diagnosed with Low-Grade Coeliac Enteropathy. Nutrients 2019, 11, 1050.
Fernández-Bañares F, Carrasco A, Rosinach M, Arau B, García-Puig R, González C, Tristán E, Zabana Y, Esteve M. A Scoring System for Identifying Patients Likely to Be Diagnosed with Low-Grade Coeliac Enteropathy. Nutrients. 2019; 11(5):1050.Chicago/Turabian Style
Fernández-Bañares, Fernando; Carrasco, Anna; Rosinach, Mercè; Arau, Beatriz; García-Puig, Roger; González, Clarisa; Tristán, Eva; Zabana, Yamile; Esteve, Maria. 2019. "A Scoring System for Identifying Patients Likely to Be Diagnosed with Low-Grade Coeliac Enteropathy." Nutrients 11, no. 5: 1050.
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