Intraepithelial lymphocytes before and after gluten challenge in children with celiac disease.

Abstract

An increase in the number of intraepithelial (IE) lymphocytes is a well-known characteristic of the jejunal lesion in patients with untreated celiac disease. 1.2 A prolonged glutenfree diet results in a return to normal villous structure and reduction to normal of the IE lymphocyte count. 3 After reintroduction of gluten, for some weeks and months the number of IE lymphocytes significantly increases in association with villous atrophy. 4.5 We have previously reported that in 46 children with untreated celiac disease, a close inverse correlation exists between the IE lymphocyte count and the blood xylose value. 6 In the present study, we wanted to see whether the IE lymphocyte count increased after a short exposure to gluten and before marked alteration in the villous pattern. We made counts of IE lymphocytes before and after a brief gluten challenge in 22 children with proved celiac disease who were aged between 3 years