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ROC-king onwards: intraepithelial lymphocyte counts, distribution and role in coeliac disease mucosal interpretation
  1. Georg Oberhuber1,
  2. Alexander Moschen2,
  3. Andreas Entenmann3,
  4. Harald Vogelsang4
  1. 1Department of Pathology, General Hospital Innsbruck, Innsbruck, Austria
  2. 2Departmentof Internal Medicine I, University Hospital Innsbruck, Innsbruck, Austria
  3. 3Departmentof Pediatry I, University Hospital Innsbruck, Innsbruck, Austria
  4. 4Department of Internal Medicine IIII, University Hospital Vienna, Vienna, Austria
  1. Correspondence to Dr Georg Oberhuber, Department of Pathology, General Hospital of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria; k.oberhuber{at}gmail.com

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We read with interest the paper of Rostami et al, which was recently published in Gut. Counting intraepithelial lymphocytes (IEL) is considered highly useful in the histological evaluation of small intestinal biopsy specimens. When combined with the assessment of mucosal architecture and of inflammatory cells in the lamina propria, a precise histological diagnosis is possible in the majority of cases. Currently, there is an ongoing debate on the number of IEL that can safely be considered diagnostic for coeliac disease (CD). In our opinion, the recently published attempt by Rostami et al1 turns out to be insignificant due to the following shortcomings: the controls used were neither sex-matched nor age-matched. Controls showing any abnormality …

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