title: Intraepithelial lymphocytes in celiac disease.
abstract: OBJECTIVE
  The aim of this study was to investigate the value of immunohistochemical characterization of different intraepithelial lymphocytes (IELs) in the diagnostic workup of celiac disease (CD).
  
  
  METHODS
  The study involved 928 consecutive adult patients undergoing endoscopy undertaken on suspicion of CD or to ascertain the dietary compliance; the control group consisted of 59 adults who underwent endoscopy because of indigestion. Small bowel mucosal morphology, CD3+, alphabeta+, and gammadelta+ IELs were determined.
  
  
  RESULTS
  CD was detected in 138 and excluded in 545 adults. CD3+ and gammadelta+ IELs both showed a sensitivity of 93% for CD; specificity was 73% and 88%, respectively. For alphabeta+ cells, the sensitivity was 83% and specificity, 66%. The mucosal morphology recovered on a gluten-free diet and the densities of different IELs, even gammadelta+ cells, decreased. Only the density of gammadelta+ cells remained elevated compared with controls.
  
  
  CONCLUSIONS
  Counting of IELs is recommended in borderline cases where the histology is difficult to interpret. An increase especially in gammadelta+ cells strengthens the probability of CD. However, IELs are not invariably increased in CD.
authors.affiliation: Department of Internal Medicine, Tampere University Hospital and Medical School, University of Tampere, Tampere, Finland.
authors.forename: Teea T
authors.initials: TT
authors.lastname: Järvinen
authors.forename: Katri
authors.initials: K
authors.lastname: Kaukinen
authors.forename: Kaija
authors.initials: K
authors.lastname: Laurila
authors.forename: Sinikka
authors.initials: S
authors.lastname: Kyrönpalo
authors.forename: Martin
authors.initials: M
authors.lastname: Rasmussen
authors.forename: Markku
authors.initials: M
authors.lastname: Mäki
authors.forename: Heikki
authors.initials: H
authors.lastname: Korhonen
authors.forename: Timo
authors.initials: T
authors.lastname: Reunala
authors.forename: Pekka
authors.initials: P
authors.lastname: Collin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy; D002446:Celiac Disease / Q000175:diagnosis / Q000276:immunology* / Q000473:pathology*; D004384:Duodenoscopy; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007413:Intestinal Mucosa / Q000276:immunology / Q000473:pathology*; D018655:Lymphocyte Count; D008214:Lymphocytes / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D017260:Receptor-CD3 Complex, Antigen, T-Cell
chemical_list: D017260:Receptor-CD3 Complex, Antigen, T-Cell