ArticleJournal of clinical immunology2014
Optimal strategies to identify aberrant intra-epithelial lymphocytes in refractory coeliac disease.
Article in Journal of clinical immunology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 52 citations in OpenAlex.
- Pooled it
- Malignancies in Celiac Disease-A Hidden Threat with Diagnostic Pitfalls.Biomedicines · 2025Review
- Guidelines for best practices in monitoring established coeliac disease in adult patients.Nature reviews. Gastroenterology & hepatology · 2024Review
- CD, or not CD, that is the question: a digital interobserver agreement study in coeliac disease.BMJ open gastroenterology · 2024Article
- Refractory celiac disease and its mimickers: a review on pathogenesis, clinical-pathological features and therapeutic challenges.Frontiers in oncology · 2023Review
- Extranodal T- and NK-cell lymphomas.Virchows Archiv : an international journal of pathology · 2023Review
- Artificial Intelligence Analysis of Celiac Disease Using an Autoimmune Discovery Transcriptomic Panel Highlighted Pathogenic Genes including BTLA.Healthcare (Basel, Switzerland) · 2022Article
- Cellular Origins and Pathogenesis of Gastrointestinal NK- and T-Cell Lymphoproliferative Disorders.Cancers · 2022Review
- Possible relationship between refractory celiac disease and malignancies.World journal of clinical oncology · 2022Review
- Intestinal and blood lymphograms as new diagnostic tests for celiac disease.Frontiers in immunology · 2022Review
- Clinical classification and long-term outcomes of seronegative coeliac disease: a 20-year multicentre follow-up study.Alimentary pharmacology & therapeutics · 2021Article
- The Evolving Landscape of Biomarkers in Celiac Disease: Leading the Way to Clinical Development.Frontiers in immunology · 2021Review
- Association Between Celiac Disease and Cancer.International journal of molecular sciences · 2020Review
- Update on lymphoproliferative disorders of the gastrointestinal tract: disease spectrum from indolent lymphoproliferations to aggressive lymphomas.Virchows Archiv : an international journal of pathology · 2020Review
- Refractory Celiac Disease.Current gastroenterology reports · 2020Review
- Updated guidelines by the European Society for the Study of Coeliac Disease.United European gastroenterology journal · 2019Article
- Intraepithelial lymphocytes, scores, mimickers and challenges in diagnosing gluten-sensitive enteropathy (celiac disease).World journal of gastroenterology · 2017Review
- Outcome of Referrals for Non-Responsive Celiac Disease in a Tertiary Center: Low Incidence of Refractory Celiac Disease in the Netherlands.Clinical and translational gastroenterology · 2017Article
- Review
- Mechanisms and management of refractory coeliac disease.Nature reviews. Gastroenterology & hepatology · 2015Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionDifferent strategies have been developed to identify those refractory celiac disease (RCD) patients who are at risk to develop an enteropathy associated T-cell lymphoma (EATL). Flow cytometric analysis of intra-epithelial lymphocytes (IEL) with an aberrant phenotype is considered the golden standard but is not widely available. Immunohistochemistry (IHC) and T-cell receptor (TCR) rearrangement studies are commonly available but may lack sensitivity and specificity. Here, we compared the three different methods in the workup of patients suspected for RCD.
methodsDuodenal biopsies from control patient (n = 5), RCD patients with moderately increased aberrant IEL populations (20-50 %: n = 14), and RCD patients with high numbers of aberrant IEL (>50 %: n = 5) as determined by flow cytometry were analysed by IHC and TCR-γ chain rearrangement analysis. Three pathologists scored the slides independently.
resultsSensitivity of IHC and TCR-γ rearrangement analysis in RCD patients with high numbers of aberrant IELs was 100 and 71 %, respectively. RCD patients with aberrant cells between 25 and 50 % however, were missed by IHC and TCR in 50 and 57 % of cases, respectively. In addition, inter-rater reliability analysis of the IHC scoring revealed coder-pair Kappa coefficients between 0.28 and 0.85.
conclusionImmunohistochemistry and to a lesser extent TCR-γ clonality analysis are sensitive in identifying patients with high numbers of aberrant IEL populations, yet miss half of RCD patients with moderately increased numbers. In addition, IHC has a high inter-observer variability. Therefore, patients suspected for RCD should undergo flow cytometric analysis of the duodenum.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.