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Duodenal intraepithelial lymphocytosis is common in children without celiac disease

Duodenal intraepithelial lymphocytosis is common in children without celiac disease, and is not meaningfully influenced by Helicobacter pylori infection, reports the latest issue of the Alimentary Pharmacology & Therapeutics.

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Increased numbers of duodenal intraepithelial lymphocytes characterize celiac disease but have also been described in nonceliacs.

Controversy exists regarding an association between increased intraepithelial lymphocytes and infection with Helicobacter pylori, which is commonly found in children.

Dr Guz-Mark and colleagues from Israel assessed the relationship between H. pylori infection and duodenal intraepithelial lymphocytes in a large cohort of children, with and without celiac disease.

The researchers reviewed gastric and duodenal biopsies of children who underwent esophagogastroduodenoscopy between 2006 and 2013 because of either recurrent abdominal pain or suspected celiac disease at Schneider Children's Medical Center of Israel, a referral center for Israel's largest Health Maintenance Organization.

The duodenal intraepithelial lymphocytes count and H. pylori presence in antral biopsies were determined for each specimen.

Among children with recurrent abdominal pain, H. pylori was present in 34%
Alimentary Pharmacology & Therapeutics

The team included children with recurrent abdominal pain or celiac disease.

Among children with recurrent abdominal pain, H. pylori was present in 34%.

The mean intraepithelial lymphocytes count in the H. pylori positive recurrent abdominal pain group was 18 per 100 enterocytes, vs. 16 in the H. pylori negative patients.

Increased intraepithelial lymphocytes counts were found in 16% of H. pylori negative, nonceliac children.

Among children with celiac disease, there was no significant difference in intraepithelial lymphocytes counts according to H. pylori status.

Dr Guz-Mark's team comments, "Our study suggests that slightly elevated duodenal intraepithelial lymphocyte counts are common in the pediatric population."

"Helicobacter pylori infection has no major influence on the intraepithelial lymphocyte counts in children with recurrent abdominal pain or children with celiac disease."

Aliment Pharmacol Ther 2014: 39(11): 1314–1320
21 May 2014

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