Year 2020 / Volume 112 / Number 6
Original
Duodenal lymphogram as a complementary tool in the diagnosis of celiac disease in adults

434-439

DOI: 10.17235/reed.2020.6391/2019

Beatriz Burgueño Gómez, Celia Escudero-Hernández, Rodrigo de Pedro, Enrique Montalvillo, David Bernardo, Elena García-Lagarto, José Antonio Garrote Adrados, Eduardo Arranz Sanz, Luis Fernández Salazar,

Abstract
Introduction: celiac disease (CD) patients have a specific pattern of lymphocytic infiltrate in the duodenal mucosa. Flow cytometry is a complementary tool for the diagnosis of CD, which allows the quantification and characterization of intraepithelial lymphocytes (IELs) by what is commonly called a lymphogram. Here we describe our experience with this technique in the diagnosis of CD in adult patients. Methods: lymphograms from 157 patients performed in our center between 2009 and 2017 were retrospectively analyzed. Fourteen patients had a previous diagnosis of CD and followed a gluten-free diet (GFD), 21 had a new diagnosis of CD and the remaining were considered as non-celiac. The association of the lymphogram results (total IELs, CD3- lymphocytes and TcRγδ lymphocytes) with the CD diagnosis, compliance with the GFD, time since diagnosis and IgA anti-TG2 titer were determined. Results: the area under the ROC curve of TcRγδ lymphocytes for CD patients varied between 0.86 and 0.86. The percentage of TcRγδ lymphocytes in GFD-treated patients was lower; 12 (8.5) vs 20.5 (8.7), p = 0.0153. However, it remained high compared to non-CD; 12 (8.5) vs 6.7 (6), p = 0.135. The time since diagnosis and IgA anti-TG2 titer correlated with the lymphogram results. Helicobacter pylori infection and treatment with angiotensin receptor antagonist 2 (ARA2) were associated with differences in the lymphogram results in patients without CD. Conclusions: the duodenal lymphogram is a reliable complementary tool in adults for the diagnosis of CD. However, compliance and duration of the GFD and other factors may condition its diagnostic capacity.
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Burgueño Gómez B, Escudero-Hernández C, de Pedro R, Montalvillo E, Bernardo D, García-Lagarto E, et all. Duodenal lymphogram as a complementary tool in the diagnosis of celiac disease in adults. 6391/2019


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Publication history

Received: 19/05/2019

Accepted: 30/08/2019

Online First: 05/02/2020

Published: 08/06/2020

Article revision time: 100 days

Article Online First time: 262 days

Article editing time: 386 days


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