Refractory coeliac sprue is a diffuse gastrointestinal disease

Verkarre, V.; Asnafi, V.; Lecomte, T.; Mariaud-de Serre, N. Patey; Leborgne, M.; Grosdidier, E.; Le Bihan, C.; Macintyre, E.; Cellier, C.; Cerf-Bensussan, N.; Brousse, N.
February 2003
Gut;Feb2003, Vol. 52 Issue 2, p205
Academic Journal
Background: Refractory coeliac sprue (RCS) with an immunophenotypically aberrant clonal intraepithelial lymphocyte (IEL) population is considered a cryptic form of intestinal T cell lymphoma. Aims: To investigate the distribution of the abnormal and monoclonal IEL population in the digestive tract of RCS patients. Patients and methods: We compared the frequency of lymphocytic gastritis (LG) and lymphocytic colitis (LC), together with IEL phenotype and T cell clonality, in gastric and colonic samples from 15 adults with RCS (all with aberrant CD3 intracytoplasmic[sup +] surface[sup -] CD8[sup -] clonal IELs on duodenojejunal biopsies), 18 patients with active coeliac disease (ACD), and 10 patients with coeliac disease (CD) on a gluten free diet (GFD-CD) by means of immunohistochemistry and multiplex polymerase chain reaction amplification of the T cell receptor γ gene (TCR-γ) rearrangement. Blood samples of nine RCS patients were also tested for clonality. Results: LG was found in 9/14 (64%), 11/18 (61%), and 3/10 (30%) patients with RCS, ACD, and GFD-CD, respectively, while LC was found in 6/11 (55%), 3/4 (75%), and 2/3 (66%) patients. Contrary to CD, all samples from patients with LG and LC showed an aberrant IEL phenotype. Monoclonal TCR-γ rearrangements were detected in 8/13 (62%), 8/10 (80%), and 4/9 (44%) of gastric, colonic, and blood samples, respectively, from RCS patients, while in CD patients such rearrangements were only found in 2/25 (8%) gastric samples. Conclusion: The immunophenotypically aberrant monoclonal IEL population present in the small intestine of patients with RCS frequently disseminates to the blood and the entire gastrointestinal epithelium, suggesting that this is a diffuse gastrointestinal disease.


Related Articles

  • A tale of two cities: typical celiac sprue presenting symptoms are signficantly more common in Turkish than in U.S. patients. Palabiyikoglu, Murat; Botoman, V A; Coban, Sahin; Bonner, Gregory F; Woodhouse, Sherry // American Journal of Gastroenterology;Sep2003 Supplement, Vol. 98, pS75 

    An abstract of the article "A Tale of Two Cities: Typical Celiac Sprue Presenting Symptoms are Signficantly More Common in Turkish Than in U.S. Patients," by Murat Palabiyikoglu, V. A. Botoman, Sahin Coban, Gregory F. Bonner, and Sherry Woodhouse is presented.

  • Celiac sprue is underdiagnosed in the veteran population. Singh, Tejinder; Khurana, Vikas; Anees, Raza; Fort, Charlton // American Journal of Gastroenterology;Sep2003 Supplement, Vol. 98, pS79 

    An abstract of the article "Celiac Sprue is Underdiagnosed in the Veteran population," by Tejinder Singh, Vikas Khurana, and Raza Anees is presented.

  • Severe Histopathological Lesion of Sprue in Patient with Minimal Evidence of Malabsorption. Samloff, I. Michael; Kelley, Maurice L.; Logan, Victor W.; Terry, Roger // Annals of Internal Medicine;Apr64, Vol. 60 Issue 4, p673 

    Reports on the case of a 50-year-old white man with severe histopathological lesion of celiac disease or nontropical sprue with minimal evidence of malabsorption. Biopsy of jejunum after four months of a gluten-free diet and three months after abandonment of the gluten-free diet; Recognition of...

  • A long story of diarrhea due to collagenous sprue. Sannier, Aurélie; Lazure, Thierry; Bouhnik, Yoram; Cazals-Hatem, Dominique // Virchows Archiv;Mar2013, Vol. 462 Issue 3, p361 

    A letter to the editor about collagenous sprue (CS) that affected the gastrointestinal system is presented.

  • Is It Gluten Sensitivity or FODMAPs Sensitivity? Gaby, Alan R. // Townsend Letter;Jun2014, Issue 371, p33 

    The article focuses on a study which examined the effects of gluten in patients with self-reported non-celiac gluten sensitivity and with presumed gluten-induced gastrointestinal symptoms.

  • A thin man with a fat problem. Surawicz, Christina M. // Cortlandt Forum;08/25/98, Vol. 11 Issue 8, p137 

    Analyzes the case of a 51 year-old businessman diagnosed with sprue and diarrhea. Diagnosis of several gastrointestinal disorders; Medical findings on the case; Treatment recommended to the patient.

  • Czy można zapobiec celiakii? Szajewska, Hanna; Dziechciarz, Piotr; Chmielewska, Anna // Gastroenterologia Polska / Gastroenterology;2008, Vol. 15 Issue 2, p119 

    Coeliac disease occurs at rates approaching 1% of the population, and is one of the most common genetically determined gastrointestinal diseases. Because coeliac disease has emerged as a public health problem, its prevention is of great importance. This article reviews data concerning the...

  • Pediatric Celiac Disease: Clinicopathologic and Genetic Aspects. Lowichik, Amy; Book, Linda // Pediatric & Developmental Pathology;Nov/Dec2003, Vol. 6 Issue 6, p470 

    Evaluation for celiac disease (CD), an autoimmune enteropathy triggered by grain proteins in wheat, barley, rye, and possibly oats, is a common indication for pediatric endoscopy and biopsy. Duodenal or jejunal biopsy remains key for the initial diagnosis of CD. Small intestinal pathology may be...

  • STEATORRHEA IN THE ADULT. Freund, Norman L. // American Journal of Gastroenterology;Jul1962, Vol. 38 Issue 1, p99 

    Presents an abstract of the study "Steatorrhea in the Adult," by J. Badenoch, published in the October 1, 1960 issue of the "British Medical Journal." Possible cause of celiac disease, idiopathic steatorrhea and tropical sprue; Common cause of obstructive jaundice, diseases of pancreas and...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics