title: Intraepithelial lymphocyte distribution differs between the bulb and the second part of duodenum.
abstract: BACKGROUND
  Evaluation of intraepithelial duodenal lymphocytosis (IDL) is important in celiac disease (CD). There is no established cut-off value for increased number of IELs in the bulb.We therefore investigated the relation between IEL counts in the bulb and duodenal specimens in non-celiac subjects.
  
  
  METHODS
  The number of CD3+ IELs was determined in specimens from the second part of the duodenum and from the bulb in 34 non-celiac subjects. The numbers of IELs in the villus tip and sides were counted and the quotient tip/side was calculated. HLA DQ2/DQ8 and serum antibodies against transglutaminase were analysed.
  
  
  RESULTS
  The mean number of IELs per 100 enterocytes (95% CI) in specimens was 14.7 (11.8-17.6) in the bulb, and 21.2 (17.0-25.5) in the second part of the duodenum (p<0.01). There was no difference in IEL count or distribution comparing patients carrying or lacking HLA DQ2/DQ8.
  
  
  CONCLUSIONS
  IEL count in non-celiac, HLA DQ2/DQ8 positive or negative patients is significantly lower in the bulb than in the second part of the duodenum. These findings implicate that the site of biopsy should be taken into account when considering duodenal lymphocytosis.
authors.affiliation: Department of internal medicine, Oskarshamn hospital, Oskarshamn, Sweden.
authors.forename: Olga
authors.initials: O
authors.lastname: Bednarska
authors.forename: Simone
authors.initials: S
authors.lastname: Ignatova
authors.forename: Charlotte
authors.initials: C
authors.lastname: Dahle
authors.forename: Magnus
authors.initials: M
authors.lastname: Ström
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017252:CD3 Complex / Q000378:metabolism*; D004378:Duodenal Diseases / Q000276:immunology* / Q000473:pathology; D004386:Duodenum / Q000166:cytology / Q000276:immunology / Q000378:metabolism; D004848:Epithelium / Q000276:immunology; D005260:Female; D019204:GTP-Binding Proteins; D005838:Genotype; D006683:HLA-DQ Antigens / Q000235:genetics; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D018655:Lymphocyte Count; D008214:Lymphocytes / Q000378:metabolism*; D008218:Lymphocytosis / Q000276:immunology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases / Q000276:immunology
chemical_list: D017252:CD3 Complex; D006683:HLA-DQ Antigens; C053186:HLA-DQ2 antigen; C109756:HLA-DQ8 antigen; D007070:Immunoglobulin A; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases; D019204:GTP-Binding Proteins