Intraepithelial Lymphocyte Cytometric Pattern Is a Useful Diagnostic Tool for Coeliac Disease Diagnosis Irrespective of Degree of Mucosal Damage and Age-A Validation Cohort

Nutrients. 2021 May 15;13(5):1684. doi: 10.3390/nu13051684.

Abstract

Introduction: The study of intraepithelial lymphocytes (IEL) by flow cytometry is a useful tool in the diagnosis of coeliac disease (CD). Previous data showed that an increase in %TCRγδ+ and decrease of %CD3- IEL constitute a typical CD cytometric pattern with a specificity of 100%. However, there are no data regarding whether there are differences in the %TCRγδ+ related to sex, age, titers of serology, and degree of histological lesion.

Study aims: To confirm the high diagnostic accuracy of the coeliac cytometric patterns. To determine if there are differences between sex, age, serology titers, and histological lesion grade.

Results: We selected all patients who fulfilled "4 of 5" rule for CD diagnosis (n = 169). There were no differences in %TCRγδ+ between sexes (p = 0.909), age groups (p = 0.986), serology titers (p = 0.53) and histological lesion grades (p = 0.41). The diagnostic accuracy of complete CD cytometric pattern was: specificity 100%, sensitivity 82%, PPV 100%, NPV 47%.

Conclusion: We confirmed, in a validation cohort, the high diagnostic accuracy of complete CD pattern irrespective of sex, age, serology titers, and grade of mucosal lesion.

Keywords: age; coeliac disease; flow cytometry; intraepithelial lymphocytes TCRγδ+; lesion grade; sex.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy
  • Celiac Disease / diagnosis*
  • Celiac Disease / immunology*
  • Child
  • Child, Preschool
  • Cohort Studies
  • Female
  • Flow Cytometry
  • Humans
  • Immunoglobulin A / blood
  • Intraepithelial Lymphocytes / immunology*
  • Male
  • Middle Aged
  • Receptors, Antigen, T-Cell, gamma-delta
  • Young Adult

Substances

  • Immunoglobulin A
  • Receptors, Antigen, T-Cell, gamma-delta