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

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

Pablo Ruiz-Ramírez  1 , Gerard Carreras  1 , Ingrid Fajardo  1 , Eva Tristán  1   2 , Anna Carrasco  1   2 , Isabel Salvador  1 , Yamile Zabana  1   2 , Xavier Andújar  1   2 , Carme Ferrer  3 , Diana Horta  1 , Carme Loras  1   2 , Roger García-Puig  4 , Fernando Fernández-Bañares  1   2 , Maria Esteve  1   2
Affiliations

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

Pablo Ruiz-Ramírez et al. Nutrients. .

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.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Gating strategy and the four patterns cytometric patterns. Complete and incomplete flow cytometric patterns (FCP) are CD related patterns.
Figure 2
Figure 2
Scatter plot and box-whisker showing the distribution of patients according to sex (a), degree of histological lesion (b), age (c), and anti-TG2 serum titers (d). Box-plot rectangle spans the interquartile range, the segment inside the rectangle shows median whereas the whiskers above and below plot, the maximum and the minimum. The dotted red line represents the stablished TCRγδ+ cut-off (>8.5%).
See this image and copyright information in PMC

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