Reviewer's report
Title:Autoimmune enteropathy with a CD8+ CD7- T-cell small bowel
intraepithelial lymphocytosis: case report and literature review
Version: 2Date:4 April 2011
Reviewer: Catherine J Streutker
Reviewer's report:
The manuscript details the case of a patient diagnosed with autoimmune
hepatitis and autoimmune enteropathy with an aberrant CD4+/CD7- T cell
phenotype in the small bowel biopsies.
Issues:
1a.) The diagnosis of autoimmune hepatitis is stated in several areas, but in
other areas is noted to be only 'probable'. I feel the evidence for this diagnosis is
quite weak; liver function tests were only mildly (approximately 2x) elevated, and
ALP was as elevated as the AST/ALT. Serologies were all negative except for
pANCA, which had a very minimal elevation according to the titre noted.
However, as the authors note, the small bowel changes are consistent with
autoimmune enteropathy, regardless of the liver pathology. I think the liver
pathology should be less emphasized in the early portions of the paper.
1b.) Issues are raised in the conclusions section without having been discussed
in the earlier sections - ie the characterization and treatment of AIE. This is not a
place for new information.
Level of interest: An article of limited interest
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Reviewer's report
Title:Autoimmune enteropathy with a CD8+ CD7- T-cell small bowel
intraepithelial lymphocytosis: case report and literature review
Version: 2Date:4 April 2011
Reviewer: Catherine J Streutker
Reviewer's report:
The manuscript details the case of a patient diagnosed with autoimmune
hepatitis and autoimmune enteropathy with an aberrant CD4+/CD7- T cell
phenotype in the small bowel biopsies.
Issues:
1a.) The diagnosis of autoimmune hepatitis is stated in several areas, but in
other areas is noted to be only 'probable'. I feel the evidence for this diagnosis is
quite weak; liver function tests were only mildly (approximately 2x) elevated, and
ALP was as elevated as the AST/ALT. Serologies were all negative except for
pANCA, which had a very minimal elevation according to the titre noted.
However, as the authors note, the small bowel changes are consistent with
autoimmune enteropathy, regardless of the liver pathology. I think the liver
pathology should be less emphasized in the early portions of the paper.
1b.) Issues are raised in the conclusions section without having been discussed
in the earlier sections - ie the characterization and treatment of AIE. This is not a
place for new information.
Level of interest: An article of limited interest
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Please review this paper.
user
Reviewer's report
Title:Autoimmune enteropathy with a CD8+ CD7- T-cell small bowel
intraepithelial lymphocytosis: case report and literature review
Version: 2Date:4 April 2011
Reviewer: Catherine J Streutker
Reviewer's report:
The manuscript details the case of a patient diagnosed with autoimmune
hepatitis and autoimmune enteropathy with an aberrant CD4+/CD7- T cell
phenotype in the small bowel biopsies.
Issues:
1a.) The diagnosis of autoimmune hepatitis is stated in several areas, but in
other areas is noted to be only 'probable'. I feel the evidence for this diagnosis is
quite weak; liver function tests were only mildly (approximately 2x) elevated, and
ALP was as elevated as the AST/ALT. Serologies were all negative except for
pANCA, which had a very minimal elevation according to the titre noted.
However, as the authors note, the small bowel changes are consistent with
autoimmune enteropathy, regardless of the liver pathology. I think the liver
pathology should be less emphasized in the early portions of the paper.
1b.) Issues are raised in the conclusions section without having been discussed
in the earlier sections - ie the characterization and treatment of AIE. This is not a
place for new information.
Level of interest: An article of limited interest
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
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