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Commentary: I see no convincing evidence of “enterocolitis,” “colitis,” or a “unique disease process”

BMJ 2011; 343 doi: (Published 09 November 2011) Cite this as: BMJ 2011;343:d6985
  1. Karel Geboes, professor emeritus
  1. 1Department of Pathology, KULeuven, Belgium
  1. karel.geboes{at}

Wording of Wakefield paper did not reflect the data shown in the grading sheets

I reviewed the gastrointestinal histology grading sheets completed by Amar Dhillon1 for 11 of 12 children with developmental disorders, who I understand were part of the clinical case series described by Wakefield and colleagues.2 The article reported that all but one child had histology showing “non-specific colitis.” It described patients as having enterocolitis and colitis, and said that the findings suggested a unique disease process.

With regard to the large bowel, a box labelled “non-specific” is ticked on one or more grading sheets for all children except one. In most cases this judgment is based on an increase in mononuclear cells in the lamina propria. However, lymphocytes and plasma cells are normally present in the lamina propria of the colon because the bowel mucosa is constantly challenged by dietary antigens …

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