ArticleJournal of clinical pathology2002
Quantitation of intraepithelial lymphocytes in human duodenum: what is normal?
Article in Journal of clinical pathology, 2002. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 1 of them a synthesis that pooled it.
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Who cites it
49 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Microscopic enteritis: Bucharest consensus.World journal of gastroenterology · 2015Guideline
- Trial
- Effect of one year of a gluten-free diet on the clinical evolution of irritable bowel syndrome plus fibromyalgia in patients with associated lymphocytic enteritis: a case-control study.Arthritis research & therapy · 2014Trial
- Milk-derived osteopontin influences the composition of the intestinal intraepithelial lymphocyte compartment.ImmunoHorizons · 2025Article
- Diagnostic Challenges in Enteropathies: A Histopathological Review.Diagnostics (Basel, Switzerland) · 2025Review
- Duodenal Biopsy Audit: Relative Frequency of Diagnoses, Key Words on Request Forms Indicating Severe Pathology, and Potential Diagnoses for Intraepithelial Lymphocytosis, as a Foundation for Developing Artificial Intelligence Diagnostic Approaches.Diagnostics (Basel, Switzerland) · 2025Article
- Histology of the Upper Gastrointestinal Tract, Morphometry and Lymphocyte Subpopulations of the Duodenal Mucosa: Insights from Healthy Individuals.International journal of molecular sciences · 2025Article
- Interpretable machine learning-based detection of coeliac disease.BMJ digital health & AI · 2025Article
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- Article
- Population-based screening for celiac disease reveals that the majority of patients are undiagnosed and improve on a gluten-free diet.Scientific reports · 2022Article
- Duodenal intraepithelial lymphocytosis in Helicobacter pylori gastritis: comparison before and after treatment.Virchows Archiv : an international journal of pathology · 2021Article
- Non-celiac wheat sensitivity: rationality and irrationality of a gluten-free diet in individuals affected with non-celiac disease: a review.BMC gastroenterology · 2021Review
- Minimal Lesions of the Small Intestinal Mucosa: More than Morphology.Digestive diseases and sciences · 2020Review
- Histopathology of Celiac Disease. Position Statements of the Italian Group of Gastrointestinal Pathologists (GIPAD-SIAPEC).Translational medicine @ UniSa · 2020Article
- Celiac disease: histology-differential diagnosis-complications. A practical approach.Pathologica · 2020Review
- A Scoring System for Identifying Patients Likely to Be Diagnosed with Low-Grade Coeliac Enteropathy.Nutrients · 2019Article
- Discriminant value of IEL counts and distribution pattern through the spectrum of gluten sensitivity: a simple diagnostic approach.Virchows Archiv : an international journal of pathology · 2018Article
- Duodenal histological features in suspected non-celiac gluten sensitivity: new insights into a still undefined condition.Virchows Archiv : an international journal of pathology · 2018Article
- Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAn increase in intraepithelial lymphocytes (IELs) is mandatory for the histological diagnosis of coeliac disease (CD). Currently, duodenal biopsies are used almost exclusively to establish the diagnosis, yet published work continues to cite an upper limit of 40 lymphocytes/100 epithelial cells, a figure derived from jejunal biopsies over 30 years ago.
aimTo establish the normal range for IEL counts in distal duodenal biopsies. MATERIALS/
methodsTwenty subjects (seven men, 13 women; median age, 34 years; range, 20-65) with a normal sugar permeability test and concurrent distal duodenal biopsies were identified. The number of IELs and epithelial cell nuclei in an uninterrupted length of surface (villous) epithelium (> 500 cells) was counted. An image analysis system was used to assess villous architecture by calculating the villous height to crypt depth ratio.
resultsThe range of IEL counts in 20 subjects was 1.8-26/100 villous epithelial cells, with a mean value of 11 and SD of 6.8. The mean villous to crypt ratio was 1.82 (SD, 0.38; range, 1.22-2.46). There was no correlation between IEL counts and villous to crypt ratio (Spearman rank correlation, -0.066; p = 0.80).
conclusionsThese results suggest that 25 IELs/100 epithelial cells (mean +2 SD) should be taken as the upper limit of the normal range for duodenal mucosa.
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