Table 1.
Clinical presentation of included patients.
Figure 1.
Representative flow cytometry dotplots of the 4 patterns.
Left: TCRγδ+ T cells; Right: CD3− cells. Non-celiac patterns: A, Normal pattern; and B, Decrease of CD3− cells. Celiac patterns: C, Increase of TCRγδ+ T cells plus decrease of CD3− cells; and D, Increase of TCRγδ+ T cells only.
Figure 2.
Intestinal deposits of anti-TG2 IgA.
Immunofluorescence staining of IgA (green) and TG2 (red). Colocalization of IgA and TG2 is shown in orange-yellow. A: Normal histology patient with no deposits. B: Marsh 1 patient with mild staining around crypts. C: Marsh 3 patient with intense subepithelial deposits.
Figure 3.
Comparison of IEL pattern between healthy controls, Marsh 3 patients and Marsh 1 patients with positive serology (serum anti-tTG2).
In all cases p<0.001, representing the differences between Marsh 3 and Marsh 1 vs. control group.
Table 2.
Mean (±SEM) values of CD3+TCRγδ+ and CD3− intraepithelial lymphocytes in the different subgroups of patients with Marsh 3 and Marsh 1 type lesions as compared to healthy controls.
Table 3.
Accuracy of the parameters evaluated for the diagnosis of CD in patients with positive serum anti-TG2*.
Figure 4.
Flow diagnostic charts showing the presence of serum anti-TG2 (TGs), the complete CD IEL cytometric pattern (CP), an isolated increase of CD3+TCRγδ+ (incomplete CD cytometric pattern), and intestinal deposits of anti-TG2 IgA (TGd; CD IF pattern) in the studied population: A. CD villous atrophy; and B. Lymphocytic enteritis.
Response to GFD is described when appropriate to fulfill the ‘gold standard’ (rule ‘4 of 5’).
Figure 5.
Comparison of CD IEL pattern between control group (A), seropositive CD Marsh 1 (B), seronegative CD Marsh 1 (C), lymphocytic enteritis secondary to Helicobacter pylori infection (D), and lymphocytic enteritis of unknown etiology (E).
IEL CD3+γδ+: p<0.001, groups B and C vs. other groups; IEL CD3−: p<0.001, groups B and C vs. control group.
Table 4.
Usefulness of both IEL flow cytometric pattern and IF pattern for the diagnosis of CD in patients with lymphocytic enteritis (Marsh 1 type lesion).
Table 5.
Mean (±SEM) values of CD3+TCRγδ+ and CD3− intraepithelial lymphocytes in the different subgroups of patients with Marsh 0 type lesions as compared to the healthy control group.
Table 6.
Study highlights.