[When gluten-free diet does not cure celiac disease].
Dietary deviations and continuous usage of gluten even in small amounts are the most common causes of poor treatment response for celiac disease. In rare refractory celiac disease symptoms and small bowel mucosal morphological damage do not heal despite a strict diet. In such cases it is important to distinguish between type I and II refractory celiac disease by using small bowel lymphocyte markers and clonality of inflammatory cells. Increased risk of small intestinal lymphoma is especially associated with type II disease, which has a poorer prognosis. Type I is often treated with corticosteroids and azathioprine.
Tampereen Yliopisto, Lääketieteen Yksikkö, Gastroenterologian Vastuualue ja TAYS.
Katri
K
Kaukinen
Tuire
T
Ilus
Martine
M
Vornanen
Pekka
P
Collin
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D001379:Azathioprine / Q000627:therapeutic use; D015415:Biomarkers / Q000032:analysis; D002446:Celiac Disease / Q000150:complications* / Q000178:diet therapy*; D055050:Diet, Gluten-Free; D006801:Humans; D007414:Intestinal Neoplasms / Q000188:drug therapy / Q000209:etiology*; D007421:Intestine, Small; D008223:Lymphoma / Q000188:drug therapy / Q000209:etiology*; D011379:Prognosis; D012307:Risk Factors; D017211:Treatment Failure
D000305:Adrenal Cortex Hormones; D000964:Antimetabolites, Antineoplastic; D015415:Biomarkers; D001379:Azathioprine