Dewar, D. H.; Johnson, M.; Ellis, H. J.; Ciclitira, P. J.
April 2004
Gut;Apr2004 Supplement 3, Vol. 53, pA6
Academic Journal
Failure to respond to a gluten free diet, either clinically or histologically, defines non-responsive coeliac disease. Refractory coeliac disease is rare and describes persisting gluten induced enteropathy when other causes have been excluded. The prognosis is poor and there is a high incidence of enteropathy associated T cell lymphoma. Therefore, all patients with primary or secondary non-responsive coeliac disease should be extensively investigated. Authors conclude that continued gluten ingestion is still the predominant cause of non-response to dietary treatment in coeliac disease. Thorough assessment will identify a potentially treatable cause in the majority of patients.


Related Articles

  • Effect of a Gluten-free Diet on the Risk of Enteropathy-associated T-cell Lymphoma in Celiac Disease. Marco Silano; Umberto Volta; Alessandro Vincenzi; Mariarita Dessì; Massimo Vincenzi // Digestive Diseases & Sciences;Apr2008, Vol. 53 Issue 4, p972 

    Abstract  Patients with celiac disease have an increased rate of enteropathy-associated T-cell lymphoma, but conflicting data are available about the protective role of a gluten-free diet with regard to the development of this malignancy. We followed 1,757 celiac patients for a...

  • Intestinal T-cell Responses in Celiac Disease - Impact of Celiac Disease Associated Bacteria. Sjöberg, Veronika; Sandström, Olof; Hedberg, Maria; Hammarström, Sten; Hernell, Olle; Hammarström, Marie-Louise // PLoS ONE;Jan2013, Vol. 8 Issue 1, Special section p1 

    A hallmark of active celiac disease (CD), an inflammatory small-bowel enteropathy caused by permanent intolerance to gluten, is cytokine production by intestinal T lymphocytes. Prerequisites for contracting CD are that the individual carries the MHC class II alleles HLA-DQ2 and/or HLA-DQ8 and is...

  • Enteropathy-type T-cell lymphoma presenting with chronic diarrhea not associated with celiac disease. Cengiz, Cem; BuIut, Safak; Boyacioglu, Sedat // Journal of Gastrointestinal & Liver Diseases;Sep2009, Vol. 18 Issue 3, p388 

    The article presents a case study of a 62-year-old woman with a 6-month history of watery diarrhea, bilious vomiting and 3 kilogram weight loss. Immunohistochemically, it revealed the presence of enteropathy-type-T-cell lymphoma (ETL) without celiac disease. The article discusses the clinical...

  • Refractory celiac disease and sprue-like intestinal disease. Freeman, Hugh James; Dickey, William // World Journal of Gastroenterology;2/14/2008, Vol. 14 Issue 6, p828 

    Celiac disease is a gluten-dependent small intestinal mucosal disorder that causes malabsorption, often with diarrhea and weight loss. Diagnosis is based on detection of typical biopsy changes in the proximal small bowel, followed by evidence for an unequivocal response to a gluten-free diet....

  • Structuration nationale pour la prise en charge des lymphomes à petites (sprue réfractaire de type II) et grandes cellules associés à la maladie cÅ“liaque. Malamut, G.; Hermine, O.; Cellier, C. // Oncologie;Jun2008, Vol. 10 Issue 6, p421 

    Low-grade and overt lymphomas are rare and severe complications of the celiac disease. The diagnostic techniques and criteria to be used for these intestinal lymphomas are very specific; they have been developed recently and remain insufficiently known. Efficient treatment does not exist. To...

  • IL-15 triggers an antiapoptotic pathway in human intraepithelial lymphocytes that is a potential new target in celiac disease-associated inflammation and lymphomagenesis. Malamut, Georgia; El Machhour, Raja; Montcuquet, Nicolas; Martin-Lannerée, Séverine; Dusanter-Fourt, Isabelle; Verkarre, Virginie; Mention, Jean-Jacques; Rahmi, Gabriel; Kiyono, Hiroshi; Butz, Eric A.; Brousse, Nicole; Cellier, Christophe; Cerf-Bensussan, Nadine; Meresse, Bertrand // Journal of Clinical Investigation;Jun2010, Vol. 120 Issue 6, p2131 

    Enteropathy-associated T cell lymphoma is a severe complication of celiac disease (CD). One mechanism suggested to underlie its development is chronic exposure of intraepithelial lymphocytes (IELs) to potent antiapoptotic signals initiated by IL-15, a cytokine overexpressed in the enterocytes of...

  • Celiac Disease. Buchan, D.J.; Gerrard, J.W. // Annals of Internal Medicine;Jul62, Vol. 57 Issue 1, p85 

    Studies problems in the diagnosis and effects of a gluten free diet on celiac disease. Role of wheat gluten in the production of steatorrhea in celiac children; Duration of symptoms; Effects of long-term treatment on jejunal mucosa.

  • Refractory celiac disease: from bench to bedside. Malamut, Georgia; Meresse, Bertrand; Cellier, Christophe; Cerf-Bensussan, Nadine // Seminars in Immunopathology;Jul2012, Vol. 34 Issue 4, p601 

    Refractory celiac disease is defined by the persistence of symptoms of malnutrition and intestinal villous atrophy for more than 6-12 months despite strict gluten-free diet in celiac patients. Diagnosis of this rare condition is made after excluding other causes of chronic small intestinal...

  • questions and answers about the neurology of gluten sensitivity. Wills, A.J. // Practical Neurology;Dec2003, Vol. 3 Issue 6, p354 

    Answers questions about the neurology of gluten sensitivity. Reliable tests for gluten sensitive enteropathy; Association of neurological conditions with celiac disease; Management of a patient with known celiac disease who presents with a neurological problem.


Read the Article


Sign out of this library

Other Topics