Studies of intestinal lymphoid tissue. IV--The predictive value of raised mitotic indices among jejunal epithelial lymphocytes in the diagnosis of gluten-sensitive enteropathy.

Publisher Website
Google Scholar
Abstract
Considerable blast-transformation and mitotic activity occurs among epithelial lymphocytes of untreated celiac mucosa. The proliferative activity of epithelial lymphocytes (expressed as percentage mitotic index) in the prospective diagnosis of celiac disease, in comparison with other conditions such as lymphoma, Crohn''s disease and immunodeficiency, which are often associated with malabsorption and flattening of the jejunal mucosa, was studied. A high mitotic index (> 0.2%) clearly distinguishes and hence predicts, gluten-associated enteropathies (including dermatitis herpetiformis and malignant histiocytosis) from others in which gluten plays no etiological role and where the mitotic index differs insignificantly from normal control mucosae (.mchlt. 0.2%). The mitotic index is raised in so-called nonresponsive celiacs, thus suggesting that such patients may also be gluten-sensitive despite their subsequent failure to respond morphologically to dietary gluten restriction.