Commentary: duodenal intraepithelial lymphocytosis in children without coeliac disease - authors' reply.

Abstract

gastrointestinal pathology in a cohort of children in Chile with respect to RAP, H. pylori and other concurrent infection, we showed that low-grade inflammation in the duodenum, manifest by increased intraepithelial lymphocytes (IELs), was associated with RAP (>20 in 74/105 patients) compared with controls (P = 0.04). A higher IEL count was also positively associated with parasite infection, seen in nine patients (P = 0.02). We also found that RAP was not associated with H. pylori as in this current study. While this study adds to the literature that RAP is not associated with H. pylori, the use of children with RAP as a control group may not be a true reflection of normal, and low-grade inflammation as reflected by LD, may represent pathology in RAP. An ideal control group is difficult in children due to ethical considerations, but perhaps those with endoscopy for nonmucosal disease (e.g. foreign body removal) may give a truer representation of normal histology in this age group. ACKNOWLEDGEMENT Declaration of personal interests: None. Declaration of funding interests: This study was funded under the Sixth Framework Programme of the European Union, Project CONTENT (INCO-DEV-3-032136), CONICYT/BM RUE #29 and FONDECYT #1100654.