{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T16:05:20Z","timestamp":1765728320667,"version":"3.44.0"},"reference-count":43,"publisher":"BMJ","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Clin Pathol"],"published-print":{"date-parts":[[1974,10]]},"abstract":"<jats:p>Small intestinal biopsies from 43 patients with dermatitis herpetiformis have been studied. The diagnosis of dermatitis herpetiformis was made on clinical and histological criteria and the presence of IgA deposits in the uninvolved skin. The macroscopic appearance of the intestinal biopsy was flat in 13, convoluted in 10, leaves only in eight, and fingers and leaves in 12. Twenty small intestinal biopsies from patients who did not have dermatitis herpetiformis or gastrointestinal disorder showed leaves only in three and fingers and leaves in 17. The mean total lymphocyte count per 1000 epithelial cells for this control group was 159 \u00b1 SE 13; for the dermatitis herpetiformis patients with flat biopsies it was 464 \u00b1 SE 27; for the convoluted biopsies 365 \u00b1 SE 59; for leaves only 535 \u00b1 SE 39; and for the fingers and leaves biopsies 301 \u00b1 SE 31. The counts for all four groups are significantly greater than the control group (P &lt; 0.001). Three of the 43 patients with dermatitis herpetiformis had lymphocyte counts below 200 per 1000 epithelial cells, and four of our controls had counts greater than 200 but none above 300.<\/jats:p>\n               <jats:p>In the control group the mean counts for lymphocytes per 1000 epithelial cells in the basal position of the intestinal epithelium was 79 \u00b1 SE 8; in the dermatitis herpetiformis flat biopsies it was 89 \u00b1 SE 11; for the convoluted biopsies 93 \u00b1 SE 12; for the leaves only biopsies 121 \u00b1 SE 18 and for the fingers and leaves 98 \u00b1 SE 13. However, the mean lymphocyte count in the perinuclear position was 81 \u00b1 SE 7 for the controls, 362 \u00b1 SE 23 for the flat dermatitis herpetiformis biopsies; 251 \u00b1 SE 46 for the convoluted specimens; 402 \u00b1 SE 43 for the leaves only specimens, and 195 \u00b1 SE 25 for the fingers and leaves biopsies. The mean lymphocyte count for the supranuclear position was 0\u00b755 \u00b1 SE 0\u00b722 for the control group; 13\u00b77 \u00b1 SE 2\u00b73 for the flat dermatitis herpetiformis biopsies; 20\u00b70 \u00b1 SE 6\u00b79 for the convoluted biopsies; 14\u00b75 \u00b1 SE 3\u00b73 for the leaves only biopsies; and 8\u00b73 \u00b1 SE 2\u00b76 for the fingers and leaves biopsies. Thus in gluten-sensitive enteropathy the increase in lymphocytes in the intestinal epithelium is in the perinuclear and supranuclear position. The ratio of basal lymphocytes to peri- and supranuclear lymphocytes appears to be 1:1 in normal intestinal epithelium, but approximately 1:4 in the gluten-sensitive enteropathy of dermatitis herpetiformis.<\/jats:p>","DOI":"10.1136\/jcp.27.10.817","type":"journal-article","created":{"date-parts":[[2007,6,9]],"date-time":"2007-06-09T00:50:46Z","timestamp":1181350246000},"page":"817-824","source":"Crossref","is-referenced-by-count":67,"title":["The small intestine in dermatitis herpetiformis"],"prefix":"10.1136","volume":"27","author":[{"given":"Lionel","family":"Fry","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P. P.","family":"Seah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P. G.","family":"Harper","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. V.","family":"Hoffbrand","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. M. H.","family":"McMinn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1974,10,1]]},"reference":[{"key":"ref_1","first-page":"2","article-title":"Dissecting microscope appearance of intestinal mucosa","volume-title":"Intestinal Biopsy (Ciba Foundation Study Group","volume":"14","author":"Booth, C.C.; Stewart, J.S.; Holmes, R.; Brackenbury, W.","year":"1962","unstructured":"Booth, C. C., Stewart, J. S., Holmes, R., and Brackenbury, W. (1962). Dissecting microscope appearance of intestinal mucosa. In Intestinal Biopsy (Ciba Foundation Study Group No. 14), edited by G. E. W. Wolstenholme and M. P. Cameron, pp. 2-23. Churchill, London."},{"key":"ref_2","article-title":"The small intestinal mucosa in dermatitis herpetiformis","author":"Brow, J.R.; Parker, F.; Weinstein, W.M.; Rubin, C.E.","year":"1971","unstructured":"Brow, J. R., Parker, F., Weinstein, W. M., and Rubin, C. E. (1971). The small intestinal mucosa in dermatitis herpetiformis."},{"key":"ref_3","first-page":"\"355","article-title":"Severity and distribution of the small intestinal lesion and associated malabsorption","volume":"60","author":"Ferguson, A.; Murray, D.","year":"1971","unstructured":"Severity and distribution of the small intestinal lesion and associated malabsorption. Gastroenterology, 60, 355-361. Ferguson, A., and Murray, D. (1971). Quantitation of intraepithelial lymphocytes in human jejunum. Gut, 12, 988-994.","journal-title":"Gastroenterology; Quantitation of intraepithelial lymphocytes in human jejunum"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1111\/j.1365-2133.1967.tb11405.x","article-title":"Structure and function of the small intestine in dermatitis herpetiformis","volume":"79","author":"Fraser, N.G.; Murray, D.; Alexander, J.O.'D.","year":"1967","unstructured":"Fraser, N. G., Murray, D., and Alexander, J. O'D. (1967). Structure and function of the small intestine in dermatitis herpetiformis. Brit. J. Derm., 79, 509-518.","journal-title":"Brit. J. Derm"},{"key":"ref_5","first-page":"729","article-title":"Small-intestinal structure and function and haematological changes in dermatitis herpetiformis","volume":"2","author":"Fry, L.; Keir, P.; McMinn, R.M.H.; Cowan, J.D.; Hoffbrand, A.V.","year":"1967","unstructured":"Fry, L., Keir, P., McMinn, R. M. H., Cowan, J. D., and Hoffbrand, A. V. (1967). Small-intestinal structure and function and haematological changes in dermatitis herpetiformis. Lancet, 2, 729-734.","journal-title":"Lancet"},{"key":"ref_6","first-page":"557","article-title":"Effect of gluten-free diet on dermatological. intestinal, and haematological manifestations of dermatitis herpetiformis","volume":"1","author":"Fry, L.; McMinn, R.M.H.; Cowan, J.D.; Hoffbrand, A.V.","year":"1968","unstructured":"Fry, L., McMinn, R. M. H., Cowan, J. D., and Hoffbrand, A. V. (1968). Effect of gluten-free diet on dermatological. intestinal, and haematological manifestations of dermatitis herpetiformis. Lancet, 1, 557-561.","journal-title":"Lancet"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1001\/archderm.1969.01610260005001","article-title":"Gluten-free diet and reintroduction of gluten in dermatitis herpetiformis","volume":"100","author":"Fry, L.; McMinn, R.M.H.; Cowan, J.D.; Hoffbrand, A.V.","year":"1969","unstructured":"Fry, L., McMinn, R. M. H., Cowan, J. D., and Hoffbrand, A. V. (1969). Gluten-free diet and reintroduction of gluten in dermatitis herpetiformis. Arch. Derm. 100, 129-135.","journal-title":"Arch. Derm"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1111\/j.1365-2133.1974.tb06377.x","article-title":"Dermatitis herpetiformis: an evaluation of diagnostic criteria","volume":"90","author":"Fry, L.; Seah, P.P.","year":"1974","unstructured":"Fry, L., and Seah, P. P. (1974). Dermatitis herpetiformis: an evaluation of diagnostic criteria. Brit. J. Derm., 90, 137-146.","journal-title":"Brit. J. Derm"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1136\/bmj.3.5823.371","article-title":"Lymphocytic infiltration of epithelium in diagnosis of glutensensitive enteropathy","volume":"3","author":"Fry, L.; Seah, P.P.; McMinn, R.M.H.; Hoffbrand, A.V.","year":"1972","unstructured":"Fry, L., Seah, P. P., McMinn, R. M. H., and Hoffbrand, A. V. (1972). Lymphocytic infiltration of epithelium in diagnosis of glutensensitive enteropathy. Brit. med. J., 3, 371-374.","journal-title":"Brit. med. J"},{"key":"ref_10","first-page":"2","article-title":"HL-A antigen type and small-intestinal disease in dermatitis herpetiformis","author":"Gebhard, R.L.; Katz, S.I.; Marks, J.; Shuster, S.; Trapani, R.J.; Rogentine, G.N.; Strober, W.","year":"1973","unstructured":"Gebhard, R. L., Katz, S. I., Marks, J., Shuster, S., Trapani, R. J., Rogentine, G. N., and Strober, W. (1973). HL-A antigen type and small-intestinal disease in dermatitis herpetiformis. Lancet, 2,760-762.","journal-title":"Lancet"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1136\/gut.3.3.232","article-title":"Intestinal reticulosis as a complication of idiopathic steatorrhoea","volume":"3","author":"Gough, K.R.; Read, A.E.; Naish, J.M.","year":"1962","unstructured":"Gough, K. R., Read, A. E., and Naish, J. M. (1962). Intestinal reticulosis as a complication of idiopathic steatorrhoea. Gut, 3, 232-239.","journal-title":"Gut"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1016\/0002-9343(67)90071-X","article-title":"Malignancy in adult coeliac disease and idiopathic steatorrhoea","volume":"42","year":"1967","unstructured":"Harris, 0. D., Cooke, W. T., Thompson, H., and Waterhouse, J. A. H. (1967). Malignancy in adult coeliac disease and idiopathic steatorrhoea. Amer. J. Med., 42, 899-912.","journal-title":"Amer. J. Med"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1280","DOI":"10.1016\/S0140-6736(66)91692-8","article-title":"Small-bowel changes in dermatitis herpetiformis","volume":"2","author":"Marks, J.; Shuster, S.; Watson, A.J.","year":"1966","unstructured":"Marks, J., Shuster, S., and Watson, A. J. (1966). Small-bowel changes in dermatitis herpetiformis. Lancet, 2, 1280-1282.","journal-title":"Lancet"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1136\/bmj.4.5686.772","article-title":"Results of treatment of dermatitis herpetiformis with a gluten-free diet after one year","volume":"4","author":"Marks, R.; Whittle, M.W.","year":"1969","unstructured":"Marks, R., and Whittle, M. W. (1969). Results of treatment of dermatitis herpetiformis with a gluten-free diet after one year. Brit. med. J., 4, 772-775.","journal-title":"Brit. med. J"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1002\/aja.1001210318","article-title":"Electron and light microscopic observations on relationships between lymphocytes and intestinal epithelium","volume":"121","author":"Meader, R.D.; Landers, D.F.","year":"1967","unstructured":"Meader, R. D., and Landers, D. F. (1967). Electron and light microscopic observations on relationships between lymphocytes and intestinal epithelium. Amer. J. Anat., 121, 763-774.","journal-title":"Amer. J. Anat"},{"key":"ref_16","first-page":"175","article-title":"Alternate-pathway complement fixation by IgA in the skin in dermatitis herpetiformis","volume":"2","author":"Seah, P.P.; Fry, L.; Mazaheri, M.R.; Mowbray, J.F.; Hoffbrand, A.V.; Holborow, E.J.","year":"1973","unstructured":"Seah, P. P., Fry, L., Mazaheri, M. R., Mowbray, J. F., Hoffbrand, A. V., and Holborow, E. J. (1973). Alternate-pathway complement fixation by IgA in the skin in dermatitis herpetiformis. Lancet, 2, 175-177.","journal-title":"Lancet"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1101","DOI":"10.1016\/S0140-6736(68)90181-5","article-title":"Coeliac syndrome in dermatitis herpetiformis","volume":"1","author":"Shuster, S.; Watson, A.J.; Marks, J.","year":"1968","unstructured":"Shuster, S., Watson, A. J., and Marks, J. (1968). Coeliac syndrome in dermatitis herpetiformis. 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(1971)."},{"key":"ref_21","article-title":"Reports and Bulletins prepared by the Association of Clinical Biochemists The following reports and bulletins are published by the Association of Clinical Biochemists. They may be obtained from","volume-title":"London WC1H 9JR. Overseas readers should remit by British Postal or Money Order","author":"Bulletins), B.M.A.House; Square, Tavistock","unstructured":"Reports and Bulletins prepared by the Association of Clinical Biochemists The following reports and bulletins are published by the Association of Clinical Biochemists. They may be obtained from The Publishing Department, British Medical Journal (ACB Technical Bulletins), B.M.A. House, Tavistock Square, London WC1H 9JR. Overseas readers should remit by British Postal or Money Order."},{"key":"ref_22","article-title":"Automatic Dispensing Pipettes: an assessment of 35 commercial instruments","author":"BROUGHTON, P.M.G.; GOWENLOCK, A.H.; WIDDOWSON, G.M.; A, K.","year":"1967","unstructured":"Automatic Dispensing Pipettes: an assessment of 35 commercial instruments September 1967 P. M. G. BROUGHTON, A. H. GOWENLOCK, G. M. WIDDOWSON, and K. A. AHLQUIST"},{"key":"ref_23","article-title":"An Evaluation of five Commercial Flame Photometers suitable for the Simultaneous Determination of Sodium and Potassium","author":"BROUGHTON, P.M.G.","year":"1970","unstructured":"An Evaluation of five Commercial Flame Photometers suitable for the Simultaneous Determination of Sodium and Potassium March 1970 P. M. G. BROUGHTON and J. B. DAWSON"},{"key":"ref_24","first-page":"SEWELL","article-title":"Spectrophotometers: a comparative list of low-priced instruments readily available in Britain May 1970 C","author":"WILDE, E.","unstructured":"Spectrophotometers: a comparative list of low-priced instruments readily available in Britain May 1970 C. E. WILDE and P. SEWELL"},{"key":"ref_25","article-title":"Quantities and Units in Clinical Biochemistry","author":"G, P.M.","year":"1970","unstructured":"Quantities and Units in Clinical Biochemistry June 1970 P. M. G. BROUGHTON"},{"first-page":"s.","article-title":"Filter Fluorimeters: A comparative list of 18 instruments September 1970 H. BRAUNSBERG and s","key":"ref_26","unstructured":"Filter Fluorimeters: A comparative list of 18 instruments September 1970 H. BRAUNSBERG and s. s."},{"key":"ref_27","article-title":"The Assessment of Thyroid Function","author":"FLYNN, F.V.; R, J.","year":"1971","unstructured":"The Assessment of Thyroid Function March 1971 F. V. FLYNN and J. R. HOBBS","journal-title":"HOBBS"},{"article-title":"Renal Function Tests Suitable for Clinical Practice January 1972 F","author":"MITCHELL, L.","key":"ref_28","unstructured":"Renal Function Tests Suitable for Clinical Practice January 1972 F. L. MITCHELL, N. VEALL, and R. W. E."},{"article-title":"Determination of Urea by AutoAnalyzer November 1966 RUTH M","volume-title":"HASLAM","key":"ref_29","unstructured":"Determination of Urea by AutoAnalyzer November 1966 RUTH M. HASLAM"},{"key":"ref_30","article-title":"Determination of Serum Albumin by AutoAnalyzer using Bromocresol Green","author":"NORTHAM, B.E.","year":"1967","unstructured":"Determination of Serum Albumin by AutoAnalyzer using Bromocresol Green October 1967 B. E. NORTHAM and G. M. WIDDOWSON"},{"key":"ref_31","article-title":"An Assessment of the Technicon Type II Sampler Unit","author":"GRAY, B.C.","year":"1968","unstructured":"An Assessment of the Technicon Type II Sampler Unit March 1968 B. C. GRAY and G. K. MCGOWAN"},{"key":"ref_32","article-title":"Atomic Absorption Spectroscopy: an outline of its principles and a guide to the selection of instruments","author":"DAWSON, J.B.","year":"1968","unstructured":"Atomic Absorption Spectroscopy: an outline of its principles and a guide to the selection of instruments May 1968 J. B. DAWSON and P. M. G. BROUGHTON"},{"key":"ref_33","article-title":"A Guide to Automatic Pipettes","author":"G, P.M.","year":"1968","unstructured":"A Guide to Automatic Pipettes (2nd edition) June 1968 P. M. G. BROUGHTON","edition":"2nd edition"},{"article-title":"Bilirubin Standards and the Determination of Bilirubin by Manual and Technicon AutoAnalyzer Methods January 1971 BARBARA","author":"BILLING, R.U.T.H.H.A.S.L.A.M.","key":"ref_34","unstructured":"Bilirubin Standards and the Determination of Bilirubin by Manual and Technicon AutoAnalyzer Methods January 1971 BARBARA BILLING, RUTH HASLAM, and N. WALD"},{"key":"ref_35","unstructured":"Interchangeable Cells for Spectrophotometers and Fluorimeters September 1971 s. s. BROWN and A. H. GOWENLOCK","article-title":"Interchangeable Cells for Spectrophotometers and Fluorimeters September 1971 s. s. BROWN and A"},{"key":"ref_36","article-title":"Simple Tests to Detect Poisons","author":"W, B.","year":"1972","unstructured":"Simple Tests to Detect Poisons March 1972 B. W. MEADE et al.","journal-title":"MEADE et al"},{"key":"ref_37","unstructured":"Blood Gas Analysers May 1972 K. DIXON","article-title":"Blood Gas Analysers May 1972 K"},{"article-title":"Kits for Enzyme Activity Determination September 1972 s. B. ROSALKI and D","volume-title":"TARLOW","key":"ref_38","unstructured":"Kits for Enzyme Activity Determination September 1972 s. B. ROSALKI and D. TARLOW"},{"journal-title":"FLECK et al","article-title":"Assessment of Pumps Suitable for Incorporation into Existing Continuous Flow Analytical Systems November 1972 A","key":"ref_39","unstructured":"Assessment of Pumps Suitable for Incorporation into Existing Continuous Flow Analytical Systems November 1972 A. FLECK et al."},{"article-title":"Routine Clinical Measurements of Transferrin in Human Serum September 1973 K","volume-title":"DIXON","key":"ref_40","unstructured":"Routine Clinical Measurements of Transferrin in Human Serum September 1973 K. DIXON"},{"article-title":"A Guide to Automation in Clinical Chemistry May 1969 P. M","volume-title":"G. BROUGHTON","key":"ref_41","unstructured":"A Guide to Automation in Clinical Chemistry May 1969 P. M. G. BROUGHTON"},{"key":"ref_42","first-page":"P.","article-title":"Flame Photometers: a comparative list of 17 instruments readily available","volume-title":"Britain August","year":"1969","unstructured":"Flame Photometers: a comparative list of 17 instruments readily available in Britain August 1969 P."},{"key":"ref_43","article-title":"Control Materials for Clinical Biochemistry","volume-title":"STEVENS 30 Notes on the Quality of Performance of Serum Cholesterol Assays September 1973 s. s","author":"F, J.","year":"1973","unstructured":"Control Materials for Clinical Biochemistry (5th edition) September 1973 J. F. STEVENS 30 Notes on the Quality of Performance of Serum Cholesterol Assays September 1973 s. s. BROWN","edition":"5th edition"}],"container-title":["Journal of Clinical Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jcp.27.10.817","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T16:58:05Z","timestamp":1758819485000},"score":1,"resource":{"primary":{"URL":"https:\/\/jcp.bmj.com\/lookup\/doi\/10.1136\/jcp.27.10.817"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1974,10]]},"references-count":43,"journal-issue":{"issue":"10","published-online":{"date-parts":[[1974,10,1]]},"published-print":{"date-parts":[[1974,10]]}},"alternative-id":["10.1136\/jcp.27.10.817"],"URL":"https:\/\/doi.org\/10.1136\/jcp.27.10.817","relation":{},"ISSN":["0021-9746","1472-4146"],"issn-type":[{"type":"print","value":"0021-9746"},{"type":"electronic","value":"1472-4146"}],"subject":[],"published":{"date-parts":[[1974,10]]}}}