Clinical significance of colonic intraepithelial lymphocytosis in a pediatric population

Najarían, Robert M.; Hait, Elizabeth J.; Leichtner, Alan M.; Glickman, Jonathan N.; Antonioli, Donald A.; Goldsmith, Jeffrey D.

doi:10.1038/modpathol.2008.139

Cited by 17 publications

(13 citation statements)

References 29 publications

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“…Regarding the study group, lymphocytic infiltration in the upper gastrointestinal tract may indicate immunological background of this disease and may suggest that lymphocytic colitis is a disease affecting not only the large intestine, but in many cases the whole gastrointestinal tract. Similar observations have been reported by Wu and Hamilton, as well as Najarian et al [24,27] This may be supported by the coexistence of food allergy (result of disturbed immunological barrier of the intestines) in 25% patients in the study group. Statistically, inflammatory lesions in the upper gastrointestinal tract were significantly more frequent in the group of older children and influenced on manifestation of clinical symptoms of this disease (diarrhea and loss of body weight).…”

Section: International Journal Of Celiac Diseasesupporting

confidence: 89%

“…Thus, in the absence of characteristic antibodies, we can consider another (not celiac disease) cause of intraepithelial lymphocyte infiltration. [24,25,26] Ozturk et al described a child, in whom lymphocytic colitis was diagnosed when diarrhea did not finish despite gluten-free diet [12]. Regarding the study group, lymphocytic infiltration in the upper gastrointestinal tract may indicate immunological background of this disease and may suggest that lymphocytic colitis is a disease affecting not only the large intestine, but in many cases the whole gastrointestinal tract.…”

Section: International Journal Of Celiac Diseasementioning

confidence: 99%

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Celiac Disease in Course of Lymphocytic Colitis in Children

Grzybowska-Chłebowczyk¹,

Kajor²,

Więcek³

et al. 2016

IJCD

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Lymphocytic colitis belongs to the group of microscopic colitis and it was first described in 1989 by Lazenby. Diagnosis is confirmed by histopathological examination, which shows characteristic changes in the form of chronic inflammation with increased number of intraepithelial lymphocytes, more than 20/100 epithelial cells. The aim of this study was a retrospective analysis of the clinical course of lymphocytic colitis and coexisting diseases, including celiac disease, in children and adolescents. The retrospective analysis included 52 children with lymphocytic colitis, hospitalized in the Gastroenterology Department, Department of Pediatrics Medical University of Silesia Katowice. Lymphocytic inflammation of the upper gastrointestinal tract, manifested in the form of lymphocytic infiltration (> 30/100 enterocytes) associated with villi damage and crypt hypertrophy, occurred in 10 patients (19%).The occurrence of lesions in the upper gastrointestinal tract significantly correlated with the clinical manifestation of lymphocytic colitis, and was predominant in the group of older children. Despite, microscopic colitis is rare in children, it may be important to think of it in this group of age. The clinical picture and etiology of lymphocytic colitis in children, in many cases, is different than in adult. Celiac disease seems to be more prevalent in children with lymphocytic colitis.

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Section: International Journal Of Celiac Diseasesupporting

confidence: 89%

Section: International Journal Of Celiac Diseasementioning

confidence: 99%

Celiac Disease in Course of Lymphocytic Colitis in Children

Grzybowska-Chłebowczyk¹,

Kajor²,

Więcek³

et al. 2016

IJCD

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“…Only monitoring the clinical progression of these patients and following them up will answer this question. Some conditions such as Giardia, cryptosporidium and isosporan infections or inflammatory bowel disease may lead to abnormalities in bowel histology such as intraepithelial infiltrate (Marsh I) or crypt hyperplasia (Marsh II) due to chronic inflammation (5,29,41) . In the present study, perhaps patient #2 could be considered to have celiac disease in view of the presence of gastrointestinal symptoms, anti-tTG positivity, a histological diagnosis of duodenal mucosa with Marsh I and HLA DQ02 positivity.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Celiac Disease in Children With Epilepsy

Vieira

Jatobá

Matos

et al. 2013

Arq. Gastroenterol.

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-Context -Neurological symptoms have been well-documented in patients with celiac disease, nevertheless, the presumption of a greater prevalence of epilepsy in celiac patients remains controversial. Objectives -To determine the frequency of celiac disease in children and adolescents with idiopathic or cryptogenic epilepsy. Methods -A cross-sectional study. One hundred pediatric patients with non-symptomatic epilepsy were followed-up at two public pediatric neurology clinics in Salvador, Bahia, Brazil. Screening for celiac disease was performed by serial measurements of IgA anti-transglutaminase and IgA anti-endomysium antibodies, followed by bowel biopsy in positive cases. HLA DQ02 and DQ08 were investigated in seropositive individuals, assessing the type of seizures, the number of antiepileptic drugs used and the presence gastrointestinal symptoms. Results -Three (3.0%) patients tested anti-tTG-positive, two with normal duodenal mucosa (Marsh 0) and one with intraepithelial infiltrate (Marsh I). No villous atrophy of the duodenal mucosa (Marsh III) celiac disease was found. Two patients tested positive for HLA DQ02; none were DQ08 positive.Conclusion -The present study failed to prove the association between celiac disease and epilepsy. HEADINGS -Celiac disease. Epilepsy. Disabled children.

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“…These cells have the contradictory role of tolerating colonization by resident bacteria while still mounting a prompt and robust immune response against invading pathogens [ 16 ]. Moreover, intraepithelial lymphocytosis has a well-known association with other immune-mediated diseases of the gut including lymphocytic colitis, celiac disease, autoimmune enteropathy, and allergic colitis [ 17 , 18 ]. Unlike those in healthy individuals, IELs from patients with IBD do not downregulate proliferative responses of primed allogeneic peripheral blood mononuclear cells on re-challenge with antigens [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Functional intraepithelial lymphocyte changes in inflammatory bowel disease and spondyloarthritis have disease specific correlations with intestinal microbiota

et al. 2018

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BackgroundDysbiosis occurs in spondyloarthritis (SpA) and inflammatory bowel disease (IBD), which is subdivided into Crohn’s disease (CD) and ulcerative colitis (UC). The immunologic consequences of alterations in microbiota, however, have not been defined. Intraepithelial lymphocytes (IELs) are T cells within the intestinal epithelium that are in close contact with bacteria and are likely to be modulated by changes in microbiota. We examined differences in human gut-associated bacteria and tested correlation with functional changes in IELs in patients with axial SpA (axSpA), CD, or UC, and in controls.MethodsWe conducted a case-control study to evaluate IELs from pinch biopsies of grossly normal colonic tissue from subjects with biopsy-proven CD or UC, axSpA fulfilling Assessment of SpondyloArthritis International Society (ASAS) criteria and from controls during endoscopy. IELs were harvested and characterized by flow cytometry for cell surface markers. Secreted cytokines were measured by ELISA. Microbiome analysis was by 16S rRNA gene sequencing from rectal swabs. Statistical analyses were performed with the Kruskal-Wallis and Spearman’s rank tests.ResultsThe total number of IELs was significantly decreased in subjects with axSpA compared to those with IBD and controls, likely due to a decrease in TCRβ+ IELs. We found strong, significant negative correlation between peripheral lymphocyte count and IEL number. IELs secreted significantly increased IL-1β in patients with UC, significantly increased IL-17A and IFN-γ in patients with CD, and significantly increased TNF-α in patients with CD and axSpA as compared to other cohorts. For each disease subtype, IELs and IEL-produced cytokines were positively and negatively correlated with the relative abundance of multiple bacterial taxa.ConclusionsOur data indicate differences in IEL function among subjects with axSpA, CD, and UC compared to healthy controls. We propose that the observed correlation between altered microbiota and IEL function in these populations are relevant to the pathogenesis of axSpA and IBD, and discuss possible mechanisms.Trial registrationClinicalTrials.gov, NCT02389075. Registered on 17 March 2015.Electronic supplementary materialThe online version of this article (10.1186/s13075-018-1639-3) contains supplementary material, which is available to authorized users.

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Clinical significance of colonic intraepithelial lymphocytosis in a pediatric population

Cited by 17 publications

References 29 publications

Celiac Disease in Course of Lymphocytic Colitis in Children

Celiac Disease in Course of Lymphocytic Colitis in Children

Prevalence of Celiac Disease in Children With Epilepsy

Functional intraepithelial lymphocyte changes in inflammatory bowel disease and spondyloarthritis have disease specific correlations with intestinal microbiota

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