1. A Scoring System for Identifying Patients Likely to Be Diagnosed with Low-Grade Coeliac Enteropathy
- Author
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Beatriz Arau, Clarisa González, Fernando Fernández-Bañares, Yamile Zabana, Maria Esteve, Eva Tristán, Mercè Rosinach, Anna Carrasco, and Roger García-Puig
- Subjects
Adult ,Male ,medicine.medical_specialty ,lcsh:TX341-641 ,Therapeutics ,Logistic regression ,Gastroenterology ,Coeliac disease ,Article ,Enteritis ,03 medical and health sciences ,0302 clinical medicine ,Atrophy ,GTP-Binding Proteins ,Risk Factors ,Internal medicine ,medicine ,Celiac disease ,Humans ,Enteropathy ,Protein Glutamine gamma Glutamyltransferase 2 ,030212 general & internal medicine ,Nutrition and Dietetics ,Transglutaminases ,IgA anti-transglutaminase 2 deposits ,business.industry ,nutritional and metabolic diseases ,prediction ,medicine.disease ,Terapèutica ,Immunoglobulin A ,Food intolerance ,Intestines ,Celiac Disease ,medicine.anatomical_structure ,Logistic Models ,Multivariate Analysis ,Duodenum ,Intraepithelial lymphocyte ,030211 gastroenterology & hepatology ,Malaltia celíaca ,response to treatment ,Female ,business ,lcsh:Nutrition. Foods and food supply ,coeliac disease ,Food Science - 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+ (TCR&gamma, &delta, +), and CD3&minus, 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 TCR&gamma, + 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.
- Published
- 2019