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Hopper AD, Hulstone DP, Leeds JS, McAlindon ME, Dube AK, Stephenson TJ, Sanders DS. The occurrence of terminal ileal histological abnormalities in patients with celiac disease. Dig Liver Dis 2006; 38: 813-819.

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Article

Intra-epithelial Lymphocytosis of the Ileum: A Pathological Clue to Clinically Occult Adult Celiac Disease

1Departments of Medicine (Gastroenterology), University of British Columbia, Vancouver, BC, Canada

2Department of Pathology, University of British Columbia, Vancouver, BC, Canada


International Journal of Celiac Disease. 2017, Vol. 5 No. 1, 40-42
DOI: 10.12691/ijcd-5-1-6
Copyright © 2017 Science and Education Publishing

Cite this paper:
Hugh J. Freeman, Doug Webber. Intra-epithelial Lymphocytosis of the Ileum: A Pathological Clue to Clinically Occult Adult Celiac Disease. International Journal of Celiac Disease. 2017; 5(1):40-42. doi: 10.12691/ijcd-5-1-6.

Correspondence to: Hugh  J. Freeman, Departments of Medicine (Gastroenterology), University of British Columbia, Vancouver, BC, Canada. Email: hugfree@shaw.ca

Abstract

A 39-yr-old male presented with diarrhea, weight loss and rectal bleeding. Hemorrhoids were present but the colon and distal ileum were macroscopically normal. Random mucosal biopsies of the ileum and multiple sites in the colon revealed extensive ileal and focal cecal intra-epithelial lymphocytosis. Subsequent duodenal mucosal biopsies confirmed the suspicion of adult celiac disease. Later endoscopic biopies done after gluten-free diet treatment were normal. This report demonstrates that intra-epithelial lymphocytosis in the ileum may be an important pathological clue to underlying clinically occult adult celiac disease.

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