A new cause of 'non-responsiveness' in coeliac disease?
A 42 year old man presented with gluten-responsive coeliac disease and secondary pancreatic insufficiency. Subsequently his symptoms relapsed and repeat small intestinal biopsy showed villous atrophy and infiltration by leukaemic cells, despite continuation of a gluten-free diet. Serious causes of relapse and non-responsiveness in coeliac disease include enteropathy-associated T-cell lymphoma, ulcerative jejunitis and an end-stage hypoplastic mucosa. This is the first report of non-responsiveness due to infiltration by leukaemia.
Jennings
J S
JS
Division of Medicine, St James's University Hospital, Leeds, UK.
Wyatt
J I
JI
Howdle
P D
PD
D000328:Adult; D002446:Celiac Disease / Q000150:complications* / Q000178:diet therapy*; D006801:Humans; D007421:Intestine, Small / Q000473:pathology*; D015477:Leukemia, Myelomonocytic, Chronic / Q000175:diagnosis / Q000473:pathology*; D017254:Leukemic Infiltration / Q000150:complications* / Q000175:diagnosis; D008297:Male; D017211:Treatment Failure