Intraepithelial lymphocytes in celiac disease

Am J Gastroenterol. 2003 Jun;98(6):1332-7. doi: 10.1111/j.1572-0241.2003.07456.x.


Objective: The aim of this study was to investigate the value of immunohistochemical characterization of different intraepithelial lymphocytes (IELs) in the diagnostic workup of celiac disease (CD).

Methods: The study involved 928 consecutive adult patients undergoing endoscopy undertaken on suspicion of CD or to ascertain the dietary compliance; the control group consisted of 59 adults who underwent endoscopy because of indigestion. Small bowel mucosal morphology, CD3+, alphabeta+, and gammadelta+ IELs were determined.

Results: CD was detected in 138 and excluded in 545 adults. CD3+ and gammadelta+ IELs both showed a sensitivity of 93% for CD; specificity was 73% and 88%, respectively. For alphabeta+ cells, the sensitivity was 83% and specificity, 66%. The mucosal morphology recovered on a gluten-free diet and the densities of different IELs, even gammadelta+ cells, decreased. Only the density of gammadelta+ cells remained elevated compared with controls.

Conclusions: Counting of IELs is recommended in borderline cases where the histology is difficult to interpret. An increase especially in gammadelta+ cells strengthens the probability of CD. However, IELs are not invariably increased in CD.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Biopsy
  • Celiac Disease / diagnosis
  • Celiac Disease / immunology*
  • Celiac Disease / pathology*
  • Duodenoscopy
  • Female
  • Humans
  • Immunohistochemistry
  • Intestinal Mucosa / immunology
  • Intestinal Mucosa / pathology*
  • Lymphocyte Count
  • Lymphocytes / immunology*
  • Male
  • Middle Aged
  • Receptor-CD3 Complex, Antigen, T-Cell


  • Receptor-CD3 Complex, Antigen, T-Cell