title: [Lymphocytic duodenosis: etiological study and clinical presentations].
abstract: BACKGROUND
  Lymphocytic duodenosis (LD) is a characteristic lesion in the initial phases of celiac disease (CD) but can be associated with many other entities. The aim of this study was to evaluate the prevalence of distinct causes of LD and possible differences in clinical presentation according to etiology.
  
  
  METHODS
  A retrospective study was performed that included 194 patients diagnosed with LD (more than 25 intraepithelial lymphocytes per 100 epithelial cells). A preestablished strategy to evaluate the cause of the disease was followed that included celiac serology (antitransglutaminase antibodies), HLA-DQ2/DQ8 genotypes, diagnosis of Helicobacter pylori and small intestinal bacterial overgrowth (SIBO). Diagnosis of CD was established on the basis of clinical and histological response to a gluten-free diet in patients with positive serology or compatible findings on HLA-DQ2 (at least one of the alleles) or -DQ8 (both alleles) study.
  
  
  RESULTS
  The most frequent cause of LD was CD (39%), followed by SBBO (22%), H.pylori (14%), CD and SIBO (12%), and other causes (13%). Most of the patients (83%) had a compatible HLA-DQ2 or -DQ8 genotype. In these patients, the most frequent diagnosis was CD (46%), while in the absence of HLA-DQ2/DQ8, the most frequent diagnoses were SIBO (44%) and H. pylori (22%). CD was the most frequent diagnosis in patients referred for dyspepsia, diarrhea and anemia, while H. pylori was the most frequent diagnosis in patients with abdominal pain.
  
  
  CONCLUSIONS
  The most common causes of LD in our environment are CD, followed by SIBO and H. pylori infection.
authors.affiliation: Unidad de Gastroenterología y Hepatología, Hospital San Jorge, Huesca, España. Electronic address: ssantolariap@indogastro.org.
authors.forename: Santos
authors.initials: S
authors.lastname: Santolaria
authors.forename: Manuel
authors.initials: M
authors.lastname: Dominguez
authors.forename: Javier
authors.initials: J
authors.lastname: Alcedo
authors.forename: Manuel
authors.initials: M
authors.lastname: Abascal
authors.forename: M Dolores
authors.initials: MD
authors.lastname: García-Prats
authors.forename: Miguel
authors.initials: M
authors.lastname: Marigil
authors.forename: Jesus
authors.initials: J
authors.lastname: Vera
authors.forename: Margarita
authors.initials: M
authors.lastname: Ferrer
authors.forename: Miguel
authors.initials: M
authors.lastname: Montoro
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000209:etiology; D001323:Autoantibodies / Q000097:blood; D001324:Autoantigens / Q000276:immunology; D001765:Blind Loop Syndrome / Q000150:complications; D002446:Celiac Disease / Q000150:complications / Q000178:diet therapy / Q000276:immunology; D003967:Diarrhea / Q000209:etiology; D055050:Diet, Gluten-Free; D004382:Duodenitis / Q000175:diagnosis / Q000209:etiology / Q000276:immunology* / Q000473:pathology; D005260:Female; D005838:Genotype; D006683:HLA-DQ Antigens / Q000032:analysis; D016481:Helicobacter Infections / Q000150:complications / Q000382:microbiology; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D007421:Intestine, Small / Q000382:microbiology; D018655:Lymphocyte Count; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D011503:Transglutaminases / Q000276:immunology; D055815:Young Adult
chemical_list: D001323:Autoantibodies; D001324:Autoantigens; D006683:HLA-DQ Antigens; C053186:HLA-DQ2 antigen; C109756:HLA-DQ8 antigen; D011503:Transglutaminases
keywords: Bacterial overgrowth; Biopsias duodeno; Celiac disease; Duodenal biopsies; Duodenosis linfocítica; Enfermedad celíaca; Helicobacter pylori; Lymphocytic duodenosis; Sobrecrecimiento bacteriano