TITLE

Survival in refractory coeliac disease and enteropathy-associated T-cell lymphoma: retrospective evaluation of single-centre experience

AUTHOR(S)
Al-toma, A.; Verbeek, W. H. M.; Hadithi, M.; von Blomberg, B. M. E.; Mulder, C. J. J.
PUB. DATE
October 2007
SOURCE
Gut;Oct2007, Vol. 56 Issue 10, p1373
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Coeliac disease may be regarded as refractory disease (RCD) when symptoms persist or recur despite strict adherence to a gluten-free diet. RCD may be subdivided into types I and II with a phenosypically normal and aberrant intraepithelial 1-cell population, respectively. RCD I seems to respond well to azathioprine/prednisone therapy. RCD II is usually resistant to any known therapy and transition into enteropathy-associated 1-cell lymphoma (EATL) is common. Aim: To provide further insight into RCD and the development of EAtL, by reporting on long-term survival and risk of transition of RCD into EATL in a large cohort of patients with complicated coeliac disease. Design and Methods: Retrospective comparison of responses to therapy in four groups of patients with complicated coeliac disease: 43, RCD I; 50, RCD II (total), of whom 26 with RCD II developed EATL. after a period of refractoriness to a gluten-free diet (secondary EATL) and 13 were EATL patients without preceding history of complicated coeliac disease (de novo EATL). Results: No coeliac-disease-related mortality was recognised in the RCD group. The overall 5-year survival in the RCD I group it was 96%; in the RCD II (total) group was 58%; and in the RCD II group after developing EATL it was only 8%. The 2-year survival in the de novo EATL group was 20% versus 15% in secondary EATL group (p=0.63). Twenty-eight (56%) of the 50 patients with RCD II died, 23 (46%) due to EATL, 4 due to a progressive refractory state with emaciation and 1 from neurocoeliac disease. Conclusion: Remarkably, no patient with RCD I developed RCD II or EATL within the mean follow-up period of 5 years (range 2-15 years). A total of 52% of the RCD II patients developed EATL within 4-6 years after the diagnosis of RCD II. More aggressive and targeted therapies seem necessary in RCD II and EATL.
ACCESSION #
27148465

 

Related Articles

  • MACROLIPASEMIA AND CELIAC DISEASE. Garcia-Gonzalez, Miguel; Defarges-Pons, Victor; Monescillo, Alberto; Hernandez, Felix; Cano-Ruiz, Ana // American Journal of Gastroenterology;Dec1995, Vol. 90 Issue 12, p2233 

    A case of undiagnosed celiac disease associated with macrolipasemia and macroamylasemia is reported. This association is almost unique. To our knowledge, only one case has been previously diagnosed. Previous case reports about macroamylasemia and celiac disease, as well as macrolipasemia, are...

  • Correlation of Clinical and Histopathological with Endoscopic Findings of Celiac Disease in the Turkish Population. Nurten Savas; Sabiye Akbulut; Ulku Saritas; Tankut Koseoglu // Digestive Diseases & Sciences;May2007, Vol. 52 Issue 5, p1299 

    Abstract  Endoscopic findings have been described for the diagnosis of celiac disease but the relationship amond the clinical presentation, endoscopic markers, and the degree of histopathological findings is not clear. Thirty patients who were thought to have celiac disease were included...

  • Deamidation of Gliadin Peptides in Lamina Propria: Implications for Celiac Disease. D. Anthonsen; E. Knudsen; H. Sjöström // Digestive Diseases & Sciences;Nov2008, Vol. 53 Issue 11, p2917 

    Abstract  Activation of small intestinal gluten-reactive CD4 T-cells is a critical event in celiac disease. Deamidation of specific glutamine residues by tissue transglutaminase enhances the binding of T-cell activating gliadin epitopes to DQ2, increasing T-cell recognition. Our...

  • Effect of Gluten-Free Diet on Pregnancy Outcome in Celiac Disease Patients with Recurrent Miscarriages. Antonio Tursi; GianMarco Giorgetti; Giovanni Brandimarte; Walter Elisei // Digestive Diseases & Sciences;Nov2008, Vol. 53 Issue 11, p2925 

    Abstract   Purpose Available literature data show that celiac disease (CD) is a frequent cause of recurrent miscarriage. However, data are lacking for pregnancy outcome when the patient is on a gluten-free diet (GFD). A case-control study about the effect of GFD on pregnancy was...

  • Cost-effective strategy for the serological investigation of coeliac disease. Bowron, A.; Moorghen, M.; Morgan, J. E.; Osborne, J. R.; Stansbie, D.; Stone, J. E. // Annals of Clinical Biochemistry;Jul2000, Vol. 37 Issue 4, p467 

    Increased numbers of requests for serological investigation of coeliac disease, and a local trend to request both anti-gliadin antibodies (AGA) and antiendomysium antibodies (AEA) simultaneously, resulted in cost pressures that prompted a review of our practice. Serology results from all...

  • Coeliac disease. Jones, Roger; Sleet, Sarah // BMJ: British Medical Journal (Overseas & Retired Doctors Edition;2/28/2009, p539 

    The article presents an overview of difficulties that are related to the diagnosis of celiac disease, which is characterised by an intolerance to the gluten contained in wheat, rye, and barley and is a combination of a food intolerance and an autoimmune disorder. A discussion of the clinical...

  • Application of Deamidated Gliadin Antibodies in the Follow-Up of Treated Celiac Disease. de Chaisemartin, Luc; Meatchi, Tchao; Malamut, Georgia; Fernani-Oukil, Fahima; Hosking, Frédérique; Rault, Dorothée; Bellery, Fabienne; Cellier, Christophe; Dragon-Durey, Marie-Agnès // PLoS ONE;8/31/2015, Vol. 10 Issue 9, p1 

    Introduction: The role of serological tests such as IgA anti-transglutaminase autoantibodies has become increasingly important in celiac disease (CD) diagnosis. However, the efficiency of these tests for patient follow-up is controversial. We investigated the correlation of 12 different...

  • Be prepared for the next snack attack. Schwarz, Meryl // GIG Newsletter;Spring2009, Vol. 32 Issue 2, p23 

    The article provides tips for sensational snacking particularly for persons newly-diagnosed with celiac disease (CD). Readers are advised to approach gluten-free snacks as an opportunity to improve their health and to think that they are actively building good health by eating foods that are...

  • © SKIN TESTS FOR COELIAC DISEASE EMPLOYING FRACTIONS OF A GLIADIN DIGEST. Cornell, H. J.; Burns, E.; Hill, D. J. // Australian Journal of Experimental Biology & Medical Science;Aug1982, Vol. 60 Issue 4, p345 

    Gliadin sub-fractions have been tested by intradermal injection in 19 adult patients with coeliac disease in remission and in 19 healthy adult controls. Fraction 3, obtained by SP Sephadex chromatography of a peptic-tryptic digest of gliadin, produced strong reactions (areas of erythema greater...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sign out of this library

Other Topics