Abstract

It has been suggested that in doubtful cases of coeliac disease, a high CD3+ T-cell receptor gamma delta+ (TCRγδ+) intraepithelial lymphocyte count increases the likelihood of coeliac disease. Aim: To evaluate the diagnostic accuracy of both an isolated increase of TCRγδ+ cells and a coeliac lymphogram (increase of TCRγδ+ plus decrease of CD3− intraepithelial lymphocytes) evaluated by flow cytometry in the diagnosis of coeliac disease. Methods: The literature search was conducted in MEDLINE and EMBASE. The inclusion criteria were: an article that allows for the construction of a 2 × 2 table of true and false positive and true and false negative values. A diagnostic accuracy test meta-analysis was performed. Results: The search provided 49 relevant citations, of which 6 were selected for the analysis, which represented 519 patients and 440 controls. Coeliac lymphogram: The pooled S and Sp were 93% and 98%, without heterogeneity. The area under the SROC curve (AUC) was 0.98 (95% CI, 0.97–0.99). TCRγδ+: Pooled S and Sp were both 95%, with significant heterogeneity. The AUC was 0.97 (95% CI, 0.95–0.98). Conclusions: Both TCRγδ+ count and coeliac lymphogram assessed by flow cytometry in duodenal mucosal samples are associated with a high level of diagnostic accuracy for and against coeliac disease.

Highlights

  • Coeliac disease (CD) is an immune-mediated systemic disorder elicited by the ingestion of gluten in genetically susceptible individuals

  • The aim of the present study was to evaluate the diagnostic accuracy of both an isolated increase of TCRγδ+ intraepithelial lymphocyte (IEL) and a coeliac lymphogram assessed by flow cytometry in duodenal mucosal samples for CD diagnosis by performing a systematic review and meta-analysis of the current literature

  • Inclusion criteria were: (1) Any article with people of any sex, age, and race that allowed for the construction of a two-way table, extracting true positive, false positive, true negative, and false negative values for TCRγδ+ IEL counting and/or coeliac lymphogram for the diagnosis of CD; (2) TCRγδ+ and CD3− IELs assessed by flow cytometry; and (3)

Read more

Summary

Introduction

Coeliac disease (CD) is an immune-mediated systemic disorder elicited by the ingestion of gluten in genetically susceptible individuals. The pooled global prevalence of CD based on serological test results is 1.4% and based on biopsy results is 0.7% [1]. CD is characterized by the presence of a varied array of gluten-dependent clinical manifestations, CD-specific antibodies, HLA-DQ2 or HLA-DQ8 haplotypes, and enteropathy [2,3,4,5]. CD diagnosis presents no difficulties when the biopsy shows severe villous atrophy and crypt hyperplasia. Diagnostic difficulties arise especially when biopsy findings are borderline

Objectives
Methods
Results
Conclusion
Full Text
Published version (Free)

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call