Turkish Journal of Gastroenterology
Original Article

The diagnostic utility of flow cytometry in celiac disease presented isolated iron deficiency anemia


Department of Gastroenterology, Namık Kemal University School of Medicine, Tekirdağ, Turkey


Department of Internal Medicine, Namık Kemal University School of Medicine, Tekirdağ, Turkey


Department of Hematology, Namık Kemal University School of Medicine, Tekirdağ, Turkey

Turk J Gastroenterol 2019; 1: -
DOI: 10.5152/tjg.2020.191016
Read: 258 Published: 12 May 2020

Background/Aims: Flow cytometric analysis (FCA) of intestinal intra epithelial T cells (IELs) contributes to the diagnosis of celiac disease. Celiac disease may present with iron deficiency anemia alone which is considered as one of the forms of atypical celiac disease. In this study we have aimed to investigate the diagnostic utility of FCA of IELs in this atypical form.

Materials and Methods: Three groups were formed: the patients with unexplained iron deficiency (group 1), the patients with celiac disease (group 2) and the patients who underwent gastroduodenoscopy for other reasons (group 0). Duodenal biopsy samples were used for flow cytometric analysis of IELs. T cell receptor gammadelta (TCR γδ) IELs and CD3-/CD103+ IELs were determined with relevant monoclonal antibodies. Sensitivity-specificity calculation was performed to evaluate the usability of flow cytometric variables as diagnostic tests

Results: Group 1 had 22 patients, group 2 had 14 patients and group 0 had 56 patients. In the comparison of the three groups, CD3+/TCRgd + IELs were found to be higher in celiac patients than other cases. CD3+/TCRgd + IEL was evaluated for its usability as a diagnostic test. The cut-off value of CD3+/TCRgd+ IEL as 16.39% according to receiver operating characteristics (ROC) curve analysis determined celiac disease in 14 of 22 patients in group 1 with 91.7% sensitivity and 80.4% specificity.

Conclusion: Although celiac disease is diagnosed with serologic tests and histologic examination, successively, the increase in intestinal CD3+/TCR γδ+ IELs may be used as a diagnostic test and it may assist in revealing atypical forms of celiac disease.

EISSN 2148-5607