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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
Celiac disease
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:
It is part of: Nutrients, 2019, vol. 11, num. 5, p. 1050
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ISSN: 2072-6643
Appears in Collections:Articles publicats en revistes (Medicina)

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