Immune-mediated enteropathies: From bench to bedside

Abstract

Immune-mediated enteropathies are caused by excessive reactions of the intestinal immune system towards non-pathogenic molecules. Enteropathy leads to malabsorption-related symptoms and include (severe) chronic diarrhea, weight loss and vitamin deficiencies. Parenteral feeding and immunosuppressive therapy are needed in severe cases. Celiac disease has long been recognized as the most common immune-mediated enteropathy in adults, but the spectrum of immune-mediated enteropathies has been expanding. Histological and clinical features are sometimes shared among these enteropathies, and therefore it may be challenging to differentiate between them. Here, we provide an overview of immune-mediated enteropathies focused on clinical presentation, establishing diagnosis, immunopathogenesis, and treatment options.

Keywords: Autoimmune enteropathy; Celiac disease; Common variable immunodeficiency syndrome; Eosinophilic enteritis; Graft-versus-host disease; Immune-mediated enteropathy; Indolent T-cell lymphoma; Olmesartan-associated enteropathy; Refractory celiac disease.