A clinicopathological approach to the diagnosis of coeliac disease

Walker, Marjorie M.; Woodward, Jeremy

doi:10.1016/j.mpdhp.2012.08.011

Cited by 3 publications

(2 citation statements)

References 81 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 3 – 5 In a small proportion of cases and for reasons that are poorly understood, intestinal mucosal damage persists despite the removal of the environmental antigenic trigger – hence “celiac disease refractory to gluten withdrawal” or simply “refractory celiac disease” (RCD). 6 , 7 This condition is now recognized as a premalignant overture to enteropathy-associated T-cell lymphoma (EATL), which carries a grave prognosis. 8 , 9 …”

Section: Overviewmentioning

confidence: 99%

Improving outcomes of refractory celiac disease – current and emerging treatment strategies

Woodward

2016

CEG

Self Cite

View full text Add to dashboard Cite

Intestinal inflammation and symptoms of celiac disease (CD) usually respond well to gluten withdrawal, but rare cases are refractory to diet. Two types of refractory CD are discriminated on the basis of the presence or absence of an atypical population of mucosal lymphocytes that may progress to enteropathy-associated T-cell lymphoma. Challenges remain in the secure diagnosis of both types of refractory disease, and evidence on which to base treatment recommendations is flawed by the small numbers of reported patients and the use of different diagnostic strategies. Recent advances in our understanding of the mechanisms of the condition in conjunction with the development of immunomodulatory agents for managing other inflammatory diseases are helping to shape future approaches to targeted therapy. Progression will depend on collaboration and recruitment to trials. In the meantime, there is evidence to suggest that earlier diagnosis and better follow-up and management of CD may prevent the development of refractoriness.

show abstract

Section: Overviewmentioning

confidence: 99%

Improving outcomes of refractory celiac disease – current and emerging treatment strategies

Woodward

2016

CEG

Self Cite

View full text Add to dashboard Cite

show abstract

“…GFD is fully indicated also in this case. In latent form occurs only positive serological test, but during the examination of the small intestine is not present any pathology [6].…”

Section: Introductionmentioning

confidence: 99%

Celiac Disease and Cancer – Are There Potential Links? Is the Vigilance of Immune System in Celiac Disease a Double-edged Sword?

Čížková¹,

Červinková²

2016

IJCD

View full text Add to dashboard Cite

Celiac disease (CD) is a chronic immune -mediated inflammatory intestinal disorder with prevalence about 1% of the West European population. The emergence of the disease is dependent on presence of grain storage proteins from wheat, barley, and rye (collectively called gluten) and genetic predisposition. After diagnosis is immediately deployed lifelong gluten free diet (GFD) to promote villous healing. In the case of CD -like other autoimmune disease, additional complications are observed especially if dietary compliance is poor. The most serious complications are malignancies including predominantly various types of lymphomas. On the other hand recent studies indicate lower risk of colon cancer in contrast to cutaneous malignant melanoma where the results are contradictory.

show abstract

Diagnosis of coeliac disease by flow cytometry of intraepithelial lymphocytes: a new ‘gold’ standard?

Basu

Creasey

Bruggemann

et al. 2021

Frontline Gastroenterol

View full text Add to dashboard Cite

ObjectiveThe analysis of intraepithelial lymphocytes (IELs) by flow cytometry of duodenal biopsies—the ‘IEL’ lymphogram—has been proposed as a diagnostic test for coeliac disease. However, its clinical applicability has been limited due to variability in methods and definitions. This study set out to define useful parameters for the application of the IEL lymphogram to the diagnosis of coeliac disease.DesignFlow cytometry was performed on 117 sets of duodenal biopsies in 107 adult patients with active coeliac disease, long-term coeliac disease on a gluten free diet and a control group. The initial 95 samples were used for hypothesis generation for the subsequent samples comprising 12 patients with coeliac disease and 10 controls.ResultsRather than using single linear cut-offs for CD3 and T-cell receptor γδ (TCRγδ)+ve IELs, a discriminant function was identified as %CD3+ve IELs+2x(%TCRγδ+IELs)>100. This differentiated coeliac disease from control biopsies in the hypothesis generating group. These results were replicated in the validation group and found to be independent of histology in patients on long-term gluten free diet up to 12 years (combined sensitivity, 98.5%; specificity, 97.7%).ConclusionsFlow cytometric analysis of IELs is a highly sensitive and specific adjunct to serology and histological examination for the diagnosis of coeliac disease, even in individuals with coeliac disease following a gluten free diet who exhibit normal duodenal histology.

show abstract

A clinicopathological approach to the diagnosis of coeliac disease

Cited by 3 publications

References 81 publications

Improving outcomes of refractory celiac disease – current and emerging treatment strategies

Improving outcomes of refractory celiac disease – current and emerging treatment strategies

Celiac Disease and Cancer – Are There Potential Links? Is the Vigilance of Immune System in Celiac Disease a Double-edged Sword?

Diagnosis of coeliac disease by flow cytometry of intraepithelial lymphocytes: a new ‘gold’ standard?

Contact Info

Product

Resources

About

A clinicopathological approach to the diagnosis of coeliac disease

Cited by 3 publications

References 81 publications

Improving outcomes of refractory celiac disease &ndash; current and emerging treatment strategies

Improving outcomes of refractory celiac disease &ndash; current and emerging treatment strategies

Celiac Disease and Cancer – Are There Potential Links? Is the Vigilance of Immune System in Celiac Disease a Double-edged Sword?

Diagnosis of coeliac disease by flow cytometry of intraepithelial lymphocytes: a new ‘gold’ standard?

Contact Info

Product

Resources

About

Improving outcomes of refractory celiac disease – current and emerging treatment strategies

Improving outcomes of refractory celiac disease – current and emerging treatment strategies