The Value of Assessment of Intraepithelial Lymphocytes Count in Surface Epithelium of Duodenal Biopsies for the Diagnosis of Celiac Disease with the use of CD3 T-Cell Marker
Iraqi Postgraduate Medical Journal,
2018, Volume 17, Issue 1, Pages 100-108
Coeliac disease (CD) is a chronic reversible enteropathy . Increased intraepithelial infiltrate, crypt hyperplasia, and villous atrophy are the three basic features of coeliac enteropathy.
The aim of this study was to evaluate the cutoff value number of intraepithelial lymphocyte count needed for the diagnosis of CD , this is supported by the use of CD3 T-cell immunohistochemical staining.
PATIENT AND METHODS:
This is a retrospective study including 25 duodenal biopsies , the cases were divided into three groups, 11 patients their biopsies show only early celiac changes supported by 9 biopsies show histological features of advanced CD, and 5 duodenal biopsies diagnosed as duodenitis.
All paraffin embedded sections were stained with H&E stain and with immunohistochemicalmarker(CD3).
Mean age of all subjects was 19.5 years. Mean age of control group was 11.8 years. Mean age of patients with early changes was 21.8 years. Mean age of patients with celiac disease was 21.5years. There was no significant difference in mean age and sex among the three groups.
Mean IEL in celiac disease was 63.1, while it was 38.7 in patients with early changes. Mean IEL in control group was 11.6.
The least cutoff count of IEL/100enterocyte to segregate our sample into those with definite celiac disease and those who are free of disease was 20 IEL/100 enterocytes with 100 % specificity and 100% sensitivity.
Mean IEL was significantly higher in celiac disease than in patients with duodenitis and those with early changes of celiac disease
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