Discriminant Score for Celiac Disease Based on Immunohistochemical Analysis of Duodenal Biopsies. Issue 5 (May 2015)

• Record Type: Journal Article
• Authors: Tosco, Antonella; Maglio, Mariantonia; Paparo, Francesco; Greco, Luigi; Troncone, Riccardo; Auricchio, Renata
• Is Part Of: Journal of pediatric gastroenterology and nutrition. Volume 60:Issue 5(2015)
• Publication Date: 2015-05
• Subjects: Children -- Nutrition -- Periodicals; Pediatric gastroenterology -- Periodicals; Infants -- Nutrition -- Periodicals; Nutrition disorders in children -- Periodicals; Child Nutrition -- Periodicals; Digestive System -- growth & development -- Periodicals; Gastrointestinal Diseases -- Periodicals; Infant Nutrition -- Periodicals; Nutrition Disorders -- Periodicals; Child; 618.923
• DOI: 10.1097/MPG.0000000000000675
• Languages: English
• ISSNs: 0277-2116

Abstract

<abstract> <title>ABSTRACT</title> <sec> <title>Objectives:</title> <p>Celiac disease (CD) represents a spectrum, which includes cases with minor histological abnormalities (potential CD). The aim of this work is to evaluate the contribution of immunohistochemical analysis of duodenal biopsies to the diagnosis of gluten-related minor enteropathy.</p> </sec> <sec> <title>Methods:</title> <p>Duodenal biopsies from 56 patients with untreated CD and 56 controls were analyzed for CD3 and γδ intraepithelial lymphocyte number, γδ/CD3 ratio, and density of CD25+ lamina propria cells. A discriminant equation was obtained by which 61 more biopsies with normal villous architecture were blindly evaluated.</p> </sec> <sec> <title>Results:</title> <p>All of the immunohistochemical parameters were significantly different between patients with CD and controls. None of the single parameters showed sufficient specificity for CD. The combination of all of the 4 markers resulted in the following discriminant equation: discriminant score (Dscore) = (CD3 × 0.06) − (γδ × 0.119) + (CD25 × 0.012) + (γδ/CD3 × 0.131) − 4.709. Using this Dscore, patients were correctly classified as celiac or controls in 97.3% of the cases. When this equation was applied to a validation set of 61 patients with normal villous architecture and unknown diagnosis, 92.9% of those with a positive score turned out to be patients with potential CD. A normal score, however, did not exclude this condition.</p> </sec> <sec> <title>Conclusions:</title> <p>Immunohistochemistry represents a specific tool for the diagnosis of CD, but does lack sensitivity in detecting all of the potential CD cases.</p> </sec> </abstract>