Related Experiment Video
Updated: Apr 7, 2026
Recognition of Epidermal Transglutaminase by IgA and Tissue Transglutaminase 2 Antibodies in a Rare Case of Rhesus Dermatitis
Published on: December 15, 2011
Immunohistochemical CD3 staining detects additional patients with celiac disease
Amani Mubarak1, Victorien M Wolters1, Roderick H J Houwen1
1Amani Mubarak, Victorien M Wolters, Roderick HJ Houwen, Department of Pediatric Gastroenterology, University Medical Center Utrecht, Wilhelmina Children's Hospital, 3508 AB Utrecht, The Netherlands.
Insights
Immunohistochemical CD3 staining improves celiac disease diagnosis by enhancing detection of intraepithelial lymphocytosis. This method aids in accurate histological assessment, especially when routine stains are inconclusive or discordant with serology.
Area of Science:
- Gastroenterology
- Immunohistochemistry
- Pediatric Pathology
Background:
- Celiac disease diagnosis relies on histological examination of duodenal biopsies.
- Intraepithelial lymphocytosis is a key indicator, but its detection can be challenging with standard hematoxylin and eosin (HE) staining.
- Discrepancies between serological tests and histological findings can occur.
Purpose of the Study:
- To evaluate the added diagnostic value of immunohistochemical CD3 staining for intraepithelial lymphocytosis in pediatric celiac disease.
- To determine if CD3 staining improves the accuracy of Marsh classification in celiac disease.
Main Methods:
- Biopsies from 159 children were initially stained with HE and assessed using the Marsh classification.
- CD3 staining was performed and evaluated independently.
- Results were compared between HE and CD3 staining, and correlated with serological findings.
Main Results:
- CD3 staining revealed discrepancies in 12.6% of cases compared to HE staining.
- Celiac disease diagnosis (Marsh II-III) was altered in 6.3% of patients, with 9 cases initially missed by HE.
- Detection of intraepithelial lymphocytosis (Marsh I) improved in 12.3% of patients, with 9 cases identified by CD3 staining but missed by HE.
Conclusions:
- Immunohistochemical CD3 staining offers significant additional value in the histological diagnosis of celiac disease.
- CD3 staining is recommended when histological findings on HE sections contradict serological results or when intraepithelial lymphocytosis is suspected but not clearly identified.
Aim:
To investigate whether performing immunohistochemical CD3 staining, in order to improve the detection of intra-epithelial lymphocytosis, has an additional value in the histological diagnosis of celiac disease.
Methods:
Biopsies obtained from 159 children were stained by hematoxylin and eosin (HE) and evaluated using the Marsh classification. CD3 staining was subsequently evaluated separately and independently.
Results:
Differences in evaluation between the routine HE sections and CD3 staining were present in 20 (12.6%) cases. In 10 (6.3%) patients the diagnosis of celiac disease (Marsh II and III) changed on examination of CD3 staining: in 9 cases, celiac disease had initially been missed on the HE sections, while 1 patient had been over-diagnosed on the routine sections. In all patients, the final diagnosis based on CD3 staining, was concordant with serological results, which was not found previously. In the other 10 (12.3%) patients, the detection of sole intra-epithelial lymphocytosis (Marsh I) improved. Nine patients were found to have Marsh I on CD3 sections, which had been missed on routine sections. Interestingly, the only patient with negative serology had Giardiasis. Finally, in 1 patient with negative serology, in whom Marsh I was suspected on HE sections, this diagnosis was withdrawn after evaluation of the CD3 sections.
Conclusion:
Staining for CD3 has an additional value in the histological detection of celiac disease lesions, and CD3 staining should be performed when there is a discrepancy between serology and the diagnosis made on HE sections.
More Related Videos
07:39Author Spotlight: Investigating the Effects of Compounds on Intestinal Tissue Using 3D Human Cell Line Models
Published on: September 1, 2023
06:05Author Spotlight: Multiplex Immunofluorescence Combined with Spatial Image Analysis for the Clinical and Biological Assessment of the Tumor Microenvironment
Published on: June 2, 2023