Coeliac disease: Table 1

Letter: follow‐up practices in coeliac disease – intestinal biopsy after child‐to‐adult transition might be useful; authors' reply

“…We agree that the Marsh 2 category is difficult 5 and we generally apply the Corazza definitions both clinically and in this study. We intend that discharge outcomes in our cohort will be the subject of a separate study.…”

Duodenal intraepithelial lymphocytosis is common in children without coeliac disease, and is not meaningfully influenced by Helicobacter pylori infection

“…12,13 Later, Corazza and Villanacci adopted an upper limit of 25 IELs in their new histological classification for coeliac lesions. 25 The guidelines of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition for the diagnosis of CD also stated a limit of 25 IELs/100 enterocytes to define the infiltrative lesion of CD, 4 while the North American Society for Paediatric gastroenterology, Hepatology and Nutrition opted for 30 IELs in their guidelines. 5 Pellegrino et al have declared an even lower threshold of 20, to define elevated IEL counts suggesting a possibility of CD.…”

Celiac disease: diagnostic criteria in progress

“…79 When an increase in IELs is suspected as the sole marker of intestinal mucosal damage, CD3 staining by immunohistochemistry is a mandatory adjunctive technique needed to count them. 80 It must also be emphasized that non-atrophic lesions of small intestine mucosa (Fig. 1a-b), characterized by an isolated increase in the number of IELs with or without crypt hyperplasia, indicate CD in only 10% of cases because many other conditions can be responsible for an increased number of IELs in the intestinal mucosa, including the following: food allergy, gastrointestinal infection (including Helicobacter pylori infection), Crohn's disease, ulcerative colitis, common variable immunodeficiency and autoimmune disorders.…”