Coeliac Disease in Elderly Patients: Value of Coeliac Lymphogram for Diagnosis

• Main Authors: Fernando Fernández-Bañares, Sergio Farrais, Montserrat Planella, Josefa Melero, Natalia López-Palacios, Santiago Vivas, Luis Fernández-Salazar, Ana Pilar Lanzarote, Pablo Ruiz-Ramírez, Marta Aguilar-Criado, Judith Vidal, Aureli Esquerda, Cristina Serrano, Concepción Núñez
• Format: Article
• Language: English
• Published: MDPI AG 2021-08-01
• Series: Nutrients
• Subjects: coeliac; TCRγδ+; CD3−; flow cytometry; elderly
• Online Access: https://www.mdpi.com/2072-6643/13/9/2984

(1) Background: Although a meta-analysis reported that the sensitivity of CD3+ TCRγδ+ cells for coeliac disease diagnosis was >93%, a recent study has suggested that sensitivity decreased to 65% in elderly patients. (2) Aim: To evaluate whether the sensitivity of intraepithelial lymphocyte cytometric patterns for coeliac disease diagnosis changes with advanced age. (3) Methods: We performed a multicentre study including 127 coeliac disease patients ≥ 50 years: 87 with baseline cytometry (45 aged 50–59 years; 23 aged 60–69 years; 19 aged ≥ 70 years), 16 also with a follow-up cytometry (on a gluten-free diet); and 40 with only follow-up cytometry. (4) Results: In Marsh 3 patients, a sensitivity of 94.7%, 88.9% and 86.7% was observed for each age group using a cut-off value of TCRγδ+ >10% (<i>p</i> = 0.27); and a sensitivity of 84.2%, 83.4% and 53.3% for a cut-off value >14% (<i>p</i> = 0.02; 50–69 vs. ≥70 years), with difference between applying a cut-off of 10% or 14% (<i>p</i> = 0.008). The TCRγδ+ count in the ≥70 years group was lower than in the other groups (<i>p</i> = 0.014). (5) Conclusion: In coeliac patients ≥ 70 years, the TCRγδ+ count decreases and the cut-off point of >10% is more accurate than >14%.