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Nutrients
Volume 16
Issue 11
10.3390/nu16111633
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Article

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

by
Laura Gutiérrez-Rios
1,
Margalida Calafat
1,2,*,
Irene Pascual
3,
Cristina Roig
4,
Aina Teniente-Serra
5,
Laia Vergés
3,
Carlos González-Muñoza
4,
Eva Vayreda
1,
Diego Vázquez
3,
Jordi Gordillo
4,
Míriam Mañosa
1,2,
Consuelo Ramírez
3,6,
Esther Garcia-Planella
4,
Montserrat Planella
3,6 and
Eugeni Domènech
1,2,7
1
Gastroenterology Department, Hospital Universitari Germans Trias i Pujol, 08029 Badalona, Spain
2
Centro de Investigaciones Biomédicas en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), 28029 Madrid, Spain
3
Gastroenterology Department, Hospital Universitari Arnau de Vilanova, 25198 Lleida, Spain
4
Gastroenterology Department, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain
5
Immunology Department, Hospital Universitari Germans Trias i Pujol, 08029 Badalona, Spain
6
Digestive Diseases Research Group (DdRG)-IRBLleida, 25198 Lleida, Spain
7
Medicine School, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
*
Author to whom correspondence should be addressed.
Nutrients 2024, 16(11), 1633; https://doi.org/10.3390/nu16111633
Submission received: 3 April 2024 / Revised: 22 May 2024 / Accepted: 24 May 2024 / Published: 26 May 2024
(This article belongs to the Special Issue Coeliac Disease, Microscopic Colitis and Exclusion Diets—a Commemorative Issue in Honour of Dr. Fernando Fernández-Bañares)
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Abstract

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.
Keywords: coeliac disease; gluten-free diet; immunophenotype; intraepithelial lymphocytes coeliac disease; gluten-free diet; immunophenotype; intraepithelial lymphocytes

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MDPI and ACS Style

Gutiérrez-Rios, L.; Calafat, M.; Pascual, I.; Roig, C.; Teniente-Serra, A.; Vergés, L.; González-Muñoza, C.; Vayreda, E.; Vázquez, D.; Gordillo, J.; et al. The Usefulness of Intraepithelial Lymphocyte Immunophenotype Testing for the Diagnosis of Coeliac Disease in Clinical Practice. Nutrients 2024, 16, 1633. https://doi.org/10.3390/nu16111633

AMA Style

Gutiérrez-Rios L, Calafat M, Pascual I, Roig C, Teniente-Serra A, Vergés L, González-Muñoza C, Vayreda E, Vázquez D, Gordillo J, et al. The Usefulness of Intraepithelial Lymphocyte Immunophenotype Testing for the Diagnosis of Coeliac Disease in Clinical Practice. Nutrients. 2024; 16(11):1633. https://doi.org/10.3390/nu16111633

Chicago/Turabian Style

Gutiérrez-Rios, Laura, Margalida Calafat, Irene Pascual, Cristina Roig, Aina Teniente-Serra, Laia Vergés, Carlos González-Muñoza, Eva Vayreda, Diego Vázquez, Jordi Gordillo, and et al. 2024. "The Usefulness of Intraepithelial Lymphocyte Immunophenotype Testing for the Diagnosis of Coeliac Disease in Clinical Practice" Nutrients 16, no. 11: 1633. https://doi.org/10.3390/nu16111633

APA Style

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. (2024). The Usefulness of Intraepithelial Lymphocyte Immunophenotype Testing for the Diagnosis of Coeliac Disease in Clinical Practice. Nutrients, 16(11), 1633. https://doi.org/10.3390/nu16111633

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