nutrients Article Coeliac Disease in Elderly Patients: Value of Coeliac Lymphogram for Diagnosis Fernando Fernández-Bañares 1,2, * , Sergio Farrais 3 , Montserrat Planella 4 , Josefa Melero 5 , Natalia López-Palacios 6 , Santiago Vivas 7 , Luis Fernández-Salazar 8 , Ana Pilar Lanzarote 3 , Pablo Ruiz-Ramírez 1,2 , Marta Aguilar-Criado 5 , Judith Vidal 9 , Aureli Esquerda 10 , Cristina Serrano 11 and ConcepciónNúñez 12   Citation: Fernández-Bañares, F.; Farrais, S.; Planella, M.; Melero, J.; López-Palacios, N.; Vivas, S.; Fernández-Salazar, L.; Lanzarote, A.P.; Ruiz-Ramírez, P.; Aguilar-Criado, M.; et al. Coeliac Disease in Elderly Patients: Value of Coeliac Lymphogram for Diagnosis. Nutrients 2021, 13, 2984. https:// doi.org/10.3390/nu13092984 Academic Editors: Suat Simsek and Claudio Romano Received: 9 July 2021 Accepted: 25 August 2021 Published: 27 August 2021 Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affil- iations. Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/). 1 Department of Gastroenterology, Hospital Universitari Mutua Terrassa, 08221 Terrassa, Spain; pruiz@mutuaterrassa.es 2 Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, 28029 Madrid, Spain 3 Department of Gastroenterology, Hospital Fundación Jiménez Díaz, 28040 Madrid, Spain; SFarraisV@quironsalud.es (S.F.); aplanzarote@gmail.com (A.P.L.) 4 Department of Gastroenterology, Hospital Universitari Arnau de Vilanova, 25198 Lleida, Spain; mplanella.lleida.ics@gencat.cat 5 Department Immunology and Genetics, Hospital Universitario de Badajoz, 06080 Badajoz, Spain; melero.pepa@gmail.com (J.M.); marta.aguilarc@salud-juntaex.es (M.A.-C.) 6 Department of Gastroenterology, Hospital Clínico San Carlos, IdISSC, 28040 Madrid, Spain; natalia.lopa@gmail.com 7 Department of Gastroenterology, Complejo Asistencial Universitario de León, 24071 León, Spain; svivasa@gmail.com 8 Department of Gastroenterology, Hospital Clínico Universitario de Valladolid, Gerencia Regional de Salud (SACYL), Facultad de Medicina, Universidad de Valladolid, 47002 Valladolid, Spain; lfernandezsa@saludcastillayleon.es 9 Department of Flow Cytometry, CATLAB, 08232 Viladecavalls, Spain; jvidal@catlab.cat 10 Department of Clinical Laboratory, Hospital Universitari Arnau de Vilanova, 25198 Lleida, Spain; aesquerda.lleida.ics@gencat.cat 11 Department of Clinical Immunology, Hospital Fundación Jiménez Díaz, 28040 Madrid, Spain; CSerranoC@quironsalud.es 12 Laboratorio de Investigación en Genética de Enfermedades Complejas, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; conchita.npardo@gmail.com * Correspondence: ffbanares@mutuaterrassa.es Abstract: (1) Background: Although a meta-analysis reported that the sensitivity of CD3+ TCRγδ+ cells for coeliac disease diagnosis was >93%, a recent study has suggested that sensitivity decreased to 65% in elderly patients. (2) Aim: To evaluate whether the sensitivity of intraepithelial lymphocyte cytometric patterns for coeliac disease diagnosis changes with advanced age. (3) Methods: We performed a multicentre study including 127 coeliac disease patients ≥ 50 years: 87 with baseline cytometry (45 aged 50–59 years; 23 aged 60–69 years; 19 aged ≥ 70 years), 16 also with a follow-up cytometry (on a gluten-free diet); and 40 with only follow-up cytometry. (4) Results: In Marsh 3 patients, a sensitivity of 94.7%, 88.9% and 86.7% was observed for each age group using a cut- off value of TCRγδ+ >10% (p = 0.27); and a sensitivity of 84.2%, 83.4% and 53.3% for a cut-off value > 14% (p = 0.02; 50–69 vs. ≥70 years), with difference between applying a cut-off of 10% or 14% (p = 0.008). The TCRγδ+ count in the ≥70 years group was lower than in the other groups (p = 0.014). (5) Conclusion: In coeliac patients ≥ 70 years, the TCRγδ+ count decreases and the cut-off point of >10% is more accurate than >14%. Keywords: coeliac; TCRγδ+; CD3-; flow cytometry; elderly Nutrients 2021, 13, 2984. https://doi.org/10.3390/nu13092984 https://www.mdpi.com/journal/nutrients