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Review
. 2019 Mar;48(1):137-144.
doi: 10.1016/j.gtc.2018.09.010. Epub 2018 Dec 13.

Refractory Celiac Disease

Georgia Malamut  1 , Christophe Cellier  2
Affiliations
Review

Refractory Celiac Disease

Georgia Malamut et al. Gastroenterol Clin North Am. 2019 Mar.

Abstract

Refractory celiac disease (RCD) refers to persistence of malnutrition and intestinal villous atrophy for more than 1 to 2 years despite strict gluten-free diet in patients with celiac disease. Diagnosis remains difficult and impacts treatment and follow-up. RCD has been subdivided into 2 subgroups according to the normal (RCDI) or abnormal phenotype of intraepithelial lymphocytes (IELs) (RCDII). RCDII is considered as a low-grade intraepithelial lymphoma and has a poor prognosis due to gastrointestinal and extraintestinal dissemination of the abnormal IELs, and high risk of overt lymphoma.

Keywords: Cytokine IL-15; Enteropathy-associated T-cell lymphoma; Phenotype of intraepithelial lymphocytes; Refractory celiac disease.

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