Digestive Diseases and Sciences

, Volume 53, Issue 1, pp 52–61

The Absence of a Mucosal Lesion on Standard Histological Examination Does Not Exclude Diagnosis of Celiac Disease

  • Bashir M. Mohamed
  • Conleth Feighery
  • Christian Coates
  • Una O’Shea
  • David Delaney
  • Seán O’Briain
  • Jacinta Kelly
  • Mohamed Abuzakouk
Original Paper

DOI: 10.1007/s10620-007-9821-5

Cite this article as:
Mohamed, B.M., Feighery, C., Coates, C. et al. Dig Dis Sci (2008) 53: 52. doi:10.1007/s10620-007-9821-5

Abstract

Some patients with undiagnosed celiac disease have minor mucosal lesions that may not be apparent during routine histological analysis. Twenty-five such patients of our institution were discharged to their primary-care physicians despite having positive endomysial antibody serology. To re-evaluate diagnosis for these patients, immunohistological staining with antibodies to CD2, CD3, CD7, CD8, CD69, and Ki67 was conducted on original biopsies from twenty patients. Clinical, serological, and histological investigations were offered to all fourteen patients who attended for review. We observed a significantly greater (P < 0.0001) numbers of intraepithelial lymphocytes and Ki67-positive enterocytes in sections from these twenty patients than for normal controls. Of the fourteen patients who attended for further review, firm diagnosis of celiac disease was made for seven patients and diagnosis was likely for another two. Our study clearly revealed that over-reliance on standard histological findings results in failure to diagnose celiac disease.

Keywords

Celiac disease Endomysial antibodies Tissue transglutaminase antibodies Intraepithelial lymphocytes Enterocytes 

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Bashir M. Mohamed
    • 1
    • 3
  • Conleth Feighery
    • 1
    • 3
  • Christian Coates
    • 1
    • 3
  • Una O’Shea
    • 1
    • 3
  • David Delaney
    • 5
  • Seán O’Briain
    • 2
  • Jacinta Kelly
    • 4
  • Mohamed Abuzakouk
    • 1
    • 3
  1. 1.Department of ImmunologySt. James’s Hospital and Trinity College DublinDublinIreland
  2. 2.Department of HistopathologySt. James’s Hospital and Trinity College DublinDublinIreland
  3. 3.Dublin Institute of Molecular Medicine DublinDublinIreland
  4. 4.Dublin Institute of TechnologyDublinIreland
  5. 5.Department of HistopathologySt. James’s HospitalDublinIreland

Personalised recommendations