On the pathogenesis and clinical course of mesenteric lymph node cavitation and hyposplenism in coeliac disease.
BACKGROUND
Coeliac disease is a disorder characterised by malabsorption related to abnormal small bowel structure and intolerance to gluten. There are several reports of an increased risk for malignancy in coeliac disease and its relation to gluten-free, reduced gluten, or normal diet. While a normal diet is associated with an excess of cancer of the mouth, pharynx, oesophagus, and also of lymphoma, treatment with a gluten-free diet restores the cancer risk back to normal.


METHODS
In the present study, we report on a 63-year-old female patient with a history of coeliac disease for twenty years who presented with persistent diarrhoea, weight loss, and an abdominal mass.


RESULTS
The gastroenterological work-up revealed small bowel mucosal atrophy, absence of functional splenic tissue, and evidence for an involution of a mesenteric lymph node, termed cavitation.


CONCLUSIONS
This triad has been previously described to represent a rare disease entity related to coeliac disease. We report a two-year follow-up and a review of the literature on the pathogenesis, prognosis, and therapeutical implications of this disease entity.
Schmitz
Frank
F
Department of Medicine 1, Ruhr-University Bochum, Germany. frank.schmitz@uni-bochum.de
Herzig
Karl-Heinz
KH
Stüber
Eckhard
E
Tiemann
Markus
M
Reinecke-Lüthge
Axel
A
Nitsche
Rolf
R
Fölsch
Ulrich R
UR
D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001707:Biopsy, Needle; D002446:Celiac Disease / Q000150:complications / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy; D004032:Diet; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D007413:Intestinal Mucosa / Q000473:pathology; D008198:Lymph Nodes / Q000473:pathology; D008206:Lymphatic Diseases / Q000150:complications / Q000473:pathology* / Q000628:therapy; D008875:Middle Aged; D012720:Severity of Illness Index; D013158:Splenic Diseases / Q000150:complications / Q000473:pathology* / Q000628:therapy; D014057:Tomography, X-Ray Computed
D000900:Anti-Bacterial Agents