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Title: | A Scoring System for Identifying Patients Likely to Be Diagnosed with Low-Grade Coeliac Enteropathy |
Author: | Fernández Bañares, Fernando Carrasco García, Anna Rosinach, Mercè Arau, Beatriz García Puig, Roger González, Clarisa Tristán, Eva Zabana, Yamile Esteve i Comas, Maria |
Keywords: | Malaltia celíaca Terapèutica Celiac disease Therapeutics |
Issue Date: | 10-May-2019 |
Publisher: | MDPI |
Abstract: | Background & aims: Determining whether patients with lymphocytic enteritis (LE) have coeliac disease is a challenge. We analysed the variables associated with a low-grade coeliac enteropathy diagnosis in patients with suspected coeliac disease but without villous atrophy, and developed a scoring system to identify them. Methods: We collected data from 2010 through to 2016 on patients with lymphocytic enteritis and persistent symptoms compatible with the clinical spectrum of coeliac disease. One hundred and four patients starting on a gluten-free diet (GFD) were included. Duodenal biopsies were collected before the GFD and analysed for numbers of CD3+ T-cell receptor gamma delta+ (TCRγδ+), and CD3- intraepithelial lymphocytes. We performed a logistic regression analysis to identify factors associated with a low-grade coeliac enteropathy diagnosis. Results: Sixty-two patients achieved clinical remission after the GFD. Fifty of these 62 patients were diagnosed with low-grade coeliac enteropathy. Multivariate analysis identified the presence of >25% intraepithelial lymphocytosis, HLA-DQ2.5, positive serology, and increased numbers of TCRγδ+ cells with a low-grade coeliac enteropathy diagnosis. We developed a scoring system that identified patients with an area under the ROC curve (AUC) of 0.91. Scores of >10 had 86% sensitivity and 85% specificity. Conclusion: We developed a scoring system that identifies patients likely to be diagnosed with low-grade coeliac enteropathy with an AUC value of 0.91. |
Note: | Reproducció del document publicat a: https://doi.org/10.3390/nu11051050 |
It is part of: | Nutrients, 2019, vol. 11, num. 5, p. 1050 |
URI: | http://hdl.handle.net/2445/176060 |
Related resource: | https://doi.org/10.3390/nu11051050 |
ISSN: | 2072-6643 |
Appears in Collections: | Articles publicats en revistes (Medicina) |
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