Cystic lymphangioma of the mesentery and hyposplenism in celiac disease.
Celiac disease is characterized by intestinal inflammation and mucosal atrophy that improves on a gluten-free diet. Delayed diagnosis can result in diet-refractory disease known as refractory sprue, which is linked to other disorders (intestinal lymphoma, ulcerative jejunoileitis, mesenteric lymph-node cavitation, collagenous sprue, malignancy) and carries a poor prognosis. Here we report the case of a young woman diagnosed with Marsh stage 3C celiac disease with intestinal occlusion due to intra-abdominal cystic lymphangioma mimicking mesenteric lymph-node cavitation, and hyposplenism. Despite a number of prognostically negative features, the disease has been managed successfully for the past 2 years with a gluten-free diet. The pathogenesis, prognosis and therapeutic implications are discussed.
Department of Internal Medicine, Catholic University of Sacred Heart, Roma, Italy.
Luca
L
Miele
Francesco
F
Pierconti
Alessandra
A
Forgione
Vittoria
V
Vero
Giovanni
G
Cammarota
Francesco
F
Molinari
Gabriele
G
Masselli
Esmeralda
E
Capristo
Maurizio
M
Martini
Luigi M
LM
Larocca
Ignazio M
IM
Civello
Giovanni
G
Gasbarrini
Antonio
A
Grieco
D000328:Adult; D002446:Celiac Disease / Q000150:complications* / Q000175:diagnosis / Q000178:diet therapy; D005260:Female; D006801:Humans; D007422:Intestines / Q000000981:diagnostic imaging / Q000473:pathology; D010535:Laparoscopy; D018191:Lymphangioma, Cystic / Q000150:complications* / Q000175:diagnosis / Q000178:diet therapy; D008639:Mesenteric Cyst / Q000150:complications* / Q000175:diagnosis / Q000178:diet therapy; D008643:Mesentery / Q000000981:diagnostic imaging / Q000473:pathology; D013154:Spleen / Q000473:pathology*; D014057:Tomography, X-Ray Computed