Self-limited coeliac-like enteropathy: a series of 18 cases highlighting another coeliac disease mimic

Brown, Ian S., Bettington, Andrew, Bettington, Mark and Rosty, Christophe (2015) Self-limited coeliac-like enteropathy: a series of 18 cases highlighting another coeliac disease mimic. Histopathology, 68 2: 254-261. doi:10.1111/his.12752


Author Brown, Ian S.
Bettington, Andrew
Bettington, Mark
Rosty, Christophe
Title Self-limited coeliac-like enteropathy: a series of 18 cases highlighting another coeliac disease mimic
Journal name Histopathology   Check publisher's open access policy
ISSN 1365-2559
0309-0167
Publication date 2015-07-28
Sub-type Article (original research)
DOI 10.1111/his.12752
Open Access Status Not Open Access
Volume 68
Issue 2
Start page 254
End page 261
Total pages 8
Place of publication Chichester, West Sussex, United Kingdom
Publisher Wiley-Blackwell Publishing
Collection year 2016
Language eng
Formatted abstract
Aims:  To describe the clinical and pathological features of a series of patients with biopsy findings of a coeliac disease-like enteropathy in the setting of an acute illness.

Methods and results:  Eighteen cases of an abrupt-onset, self-limited illness with coeliac-like enteropathy (SLCE) were collected prospectively. Medication reaction, immune disorder, food allergy and parasitic infection were excluded. Coeliac disease was excluded by the transient nature of the illness and absence of tissue transglutaminase (TTG) elevation (nine of nine) or human leucocyte antigen (HLA)-DQ2/DQ8 haplotype (eight of nine). Clinical symptoms were recorded and histopathological findings in all gastrointestinal sites were quantified. Findings in the duodenum were compared to a coeliac disease control group. In 12 cases the clinical diagnosis was infective enteritis, probably viral in type. In six cases, a definite diagnosis was not established. Histological differences from coeliac disease included intra-epithelial neutrophil infiltration (P < 0.001), fewer intra-epithelial lymphocytes (P = 0.038) and uniform or crypt predominant intra-epithelial lymphocytosis in SCLE. One case displayed pan-gastrointestinal tract lymphocytosis. All resolved within 6 months.

Conclusions:  Histopathologists need to be aware that a coeliac disease-like enteropathy may occur in the setting of an acute gastrointestinal illness and resolve without sequelae.
Keyword Coeliac disease
Coeliac-like enteropathy
Infection
Intra-epithelial lymphocytosis
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Medicine Publications
 
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