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Duodenal intraepithelial lymphocytosis during Helicobacter pylori infection is reduced by antibiotic treatment
Author(s) -
Nahon S,
Serre N PateyMariaud,
Lejeune O,
Huchet FX,
Lahmek P,
Lesgourgues B,
Traissac L,
Bodiguel V,
Adotti F,
Tuszynski T,
Delas N
Publication year - 2006
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/j.1365-2559.2006.02358.x
Subject(s) - lymphocytosis , antibiotics , medicine , gastroenterology , intraepithelial lymphocyte , helicobacter pylori , helicobacter , pathology , microbiology and biotechnology , biology , epithelium
Aim : To evaluate clinical, biological and immunological features of patients with increased duodenal intraepithelial lymphocytes (IELs), and its relation to Helicobacter pylori (HP) and coeliac disease (CD). Methods : We have studied all patients accrued over a 4‐year period with increased duodenal IELs. Those patients were recalled for biological and immunological evaluation and a second endoscopy. Results : Twenty‐three from a total of 639 patients were identified and 17 of them were included in the study. The median duodenal IEL count was 59 per 100 epithelial cells. Twelve (71%) patients were HP+; eight of them received HP eradication. At the second endoscopy the duodenal IEL count was significantly lower 2 months after HP eradication (73 versus 28), while the IEL count was unchanged in those patients seronegative for HP ( n = 5) or those in whom it was not eradicated ( n = 4) (55 versus 55). No patient had coeliac antibodies, four expressed HLA‐DQ2, lower than in the general population, and the prevalence of CD was 2% (12/639 patients). Conclusion : In some cases an increased duodenal IEL count may be due to an inappropriate host response to HP. HP screening and eradication should be considered before recommending a gluten‐free diet.