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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 al 1 turns out to be insignificant due to the following shortcomings: the controls used were neither sex-matched nor age-matched. Controls showing any abnormality …
Contributors GO planned to write the letter and made a first draft. GO, AM, AE and HV modified the first draft and wrote together the final version.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.