Intraepithelial lymphocytes in duodenum from Brazilian adolescents with type 1 diabetes. Influence of Helicobacter pylori.
BACKGROUND
An increased number of intraepithelial lymphocytes (IELs) can be the only histological feature in early stages of celiac disease (CD). This is also presented in duodenum of patients with Helicobacter pylori-associated gastritis and in autoimmune diseases. Because CD is frequently associated with type 1 diabetes mellitus, we analyzed the density of IELs in the distal duodenum of non-celiac diabetic patients associated or not with H.pylori infection.


METHODS
IEL density and the presence of H.pylori were determined in biopsies of the distal duodenum and gastric antrum and body obtained from Brazilian diabetic adolescents who were negative for anti-human tissue transglutaminase and anti-endomysial. The results were compared with the histological findings of gastric and duodenal biopsies obtained from non-diabetic older children and adolescents.


RESULTS
H.pylori was detected in 33.3% of diabetic patients and in 56.7% of the control group. No association was observed between the presence of H.pylori and an increased lymphocyte density in the distal duodenum in either group. Diabetic patients presented a duodenal IEL density similar to that of the control group. Lymphocytic gastritis was not identified in any of the biopsies analyzed.


CONCLUSIONS
The density of IELs in the distal duodenum of diabetic adolescents did not differ from that observed in older children and adolescents without this autoimmune disease. H.pylori infection, which is frequent among adolescents from developing countries, did not modify lymphocyte density in the distal duodenum in the absence of lymphocytic gastritis.
Cabral
Virgínia Lúcia Ribeiro
VL
Division of Gastroenterology, Department of Internal Medicine, Universidade Federal de São Paulo, São Paulo, Brazil. virginiacabral@terra.com.br
Patrício
Francy Reis Da Silva
FR
Gabbay
Mônica Andrade Lima
MA
Dib
Sérgio Atala
SA
Miszputen
Sender Jankiel
SJ
D000293:Adolescent; D001938:Brazil; D003922:Diabetes Mellitus, Type 1 / Q000276:immunology / Q000382:microbiology / Q000473:pathology*; D004386:Duodenum / Q000166:cytology / Q000473:pathology*; D005260:Female; D005756:Gastritis / Q000276:immunology / Q000382:microbiology / Q000473:pathology*; D016481:Helicobacter Infections / Q000276:immunology / Q000382:microbiology / Q000473:pathology*; D016480:Helicobacter pylori / Q000254:growth & development / Q000276:immunology; D006801:Humans; D007150:Immunohistochemistry; D018655:Lymphocyte Count; D008218:Lymphocytosis / Q000276:immunology / Q000382:microbiology / Q000473:pathology*; D008297:Male