title: MALTectomy (appendectomy/tonsillectomy) does not influence the occurrence or mode of presentation of adult celiac disease.
abstract: OBJECTIVE
  Recent reports suggest that appendectomy may protect against the development of ulcerative colitis. Depletion of mucosal helper T-cells is the suggested mechanism. Because mucosal T-cell activity has an even more critical role in the pathogenesis of celiac disease, our objective was to determine whether the development or mode of presentation of this disorder is influenced by appendectomy and/or tonsillectomy.
  
  
  METHODS
  One hundred fifty consecutive adult celiac patients were compared with 138 consecutive patients examined at orthopedic clinics. One hundred twenty consecutive patients with ulcerative colitis from the same ethnogeographic population were included as positive disease control.
  
  
  RESULTS
  Contrary to the previous findings in ulcerative colitis, which were again confirmed in this study, appendectomy and/or tonsillectomy did not influence the occurrence of celiac disease. In addition, presenting features, predefined in the study protocol, did not differ significantly in the appendectomy and nonappendectomy celiac patients.
  
  
  CONCLUSIONS
  Resection of mucosa-associated lymphoid tissue (MALT) does not influence the occurrence or the mode of presentation of adult celiac disease. Therefore, in this classical example of a T-cell-mediated disorder, the hypothesis that surgical depletion of mucosal T-cells has a protective effect or influences the clinical manifestations cannot be supported.
authors.affiliation: Department of Medicine, National University of Ireland, Cork.
authors.forename: P
authors.initials: P
authors.lastname: O'Gorman
authors.forename: D
authors.initials: D
authors.lastname: Bennett
authors.forename: E
authors.initials: E
authors.lastname: Kavanagh
authors.forename: L B
authors.initials: LB
authors.lastname: Twohig
authors.forename: G C
authors.initials: GC
authors.lastname: O'Sullivan
authors.forename: P
authors.initials: P
authors.lastname: O'Regan
authors.forename: F
authors.initials: F
authors.lastname: Shanahan
mesh_terms: D000328:Adult; D001062:Appendectomy; D016022:Case-Control Studies; D002446:Celiac Disease / Q000453:epidemiology / Q000517:prevention & control*; D003093:Colitis, Ulcerative / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D006801:Humans; D008221:Lymphoid Tissue / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000276:immunology; D012307:Risk Factors; D013601:T-Lymphocytes / Q000276:immunology; D014068:Tonsillectomy