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Coeliac biopsies: numbers are valid, alphabets not
  1. Kamran Rostami1,
  2. Arzu Ensari2,
  3. Carolina Ciacci3,
  4. Amitabh Srivastava4,
  5. Umberto Volta5,
  6. Vincenzo Villanacci6,
  7. Michael N Marsh7,8
  1. 1 Department of Gastroenterology, Milton Keynes Hospital NHS Foundation Trust, Milton Keynes, UK
  2. 2 Department of Pathology, Ankara University Medical School, Ankara, Turkey
  3. 3 Department of Medicine and Surgery, Scuola Medica Salernitana, University of Salerno, Salerno, Italy
  4. 4 Department of Pathology, Brigham and Women’s Hospital, Boston, Massachusetts, USA
  5. 5 Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
  6. 6 Department of Pathology, Institute of Pathology Spedali Civili, Brescia, Italy
  7. 7 Department of Gastroenterology, Luton and Dunstable University Hospital, Luton, UK
  8. 8 Wolfson College, University of Oxford, Oxford, United Kingdom
  1. Correspondence to Dr Kamran Rostami, Department of Gastroenterology, Milton Keynes University Hospital, Standing Way, Eaglestone, Milton Keynes MK6 5LD, UK; kamran.rostami{at}

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We thank Gut for requesting responses to this letter from Oberhuber and colleagues.1 We were amazed that they chose to dismiss our intraepithelial lymphocytes (IEL) data as invalid2 on grounds of not being age/gender matched with controls. But this disregards all the other data of clinicians and pathologists in the field, and the rigorous reviewing processes that our article went through before publication in Gut. This dismissal reflects an aberrant viewpoint1 lacking widespread support. In real life, pathologists do sign off biopsies, while diagnoses are rendered without full clinical details, although with appropriately worded caveats.

We aimed, specifically, to reduce the enormous …

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  • Contributors KR, AE, CC, AS, UV, VV and MNM have written their responses, and the final version of the letter based on the written responses and email discussion was summarized and formulated by MNM. The discussion was coordinated by KR. The authors have revised and agreed on the final version of the manuscript after several revisions.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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