Refractory celiac disease

Abdul R. Rishi, Alberto Rubio-Tapia, Joseph A Murray

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Refractory celiac disease (RCD) affects patients who have failed to heal after 6–12 months of a strict gluten-free diet (GFD) and when other causes of symptoms (including malignancy) have been ruled out. It may also occur in patients who previously had responded to a long-term GFD. RCD may be categorized as RCD1 (normal immunophenotype) and RCD2 (aberrant immunophenotype). RCD1 usually responds to a continued GFD, nutritional support, and therapeutic agents such as corticosteroids. In contrast, clinical response in RCD2 is incomplete and prognosis is often poor. RCD (particularly RCD2) is associated with serious complications, such as ulcerative jejunitis and enteropathy-associated T-cell lymphoma (EATL). Strict clinical and laboratory criteria should be used to diagnose RCD and specialized tests for aberrancy and clonality should be interpreted in the context of their sensitivity and specificity. Adequate nutritional support and anti-inflammatory treatment may even allow patients with RCD2 to attain a clinical remission.

Original languageEnglish (US)
Pages (from-to)1-10
Number of pages10
JournalExpert Review of Gastroenterology and Hepatology
DOIs
StateAccepted/In press - Dec 17 2015

Fingerprint

Celiac Disease
Gluten-Free Diet
Nutritional Support
Enteropathy-Associated T-Cell Lymphoma
Adrenal Cortex Hormones
Anti-Inflammatory Agents
Sensitivity and Specificity
Therapeutics
Neoplasms

Keywords

  • Celiac disease
  • gluten
  • immune disorder
  • refractory celiac disease
  • small intestine

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Refractory celiac disease. / Rishi, Abdul R.; Rubio-Tapia, Alberto; Murray, Joseph A.

In: Expert Review of Gastroenterology and Hepatology, 17.12.2015, p. 1-10.

Research output: Contribution to journalArticle

Rishi, Abdul R. ; Rubio-Tapia, Alberto ; Murray, Joseph A. / Refractory celiac disease. In: Expert Review of Gastroenterology and Hepatology. 2015 ; pp. 1-10.
@article{dd119b70fa9b416986640b76000f1449,
title = "Refractory celiac disease",
abstract = "Refractory celiac disease (RCD) affects patients who have failed to heal after 6–12 months of a strict gluten-free diet (GFD) and when other causes of symptoms (including malignancy) have been ruled out. It may also occur in patients who previously had responded to a long-term GFD. RCD may be categorized as RCD1 (normal immunophenotype) and RCD2 (aberrant immunophenotype). RCD1 usually responds to a continued GFD, nutritional support, and therapeutic agents such as corticosteroids. In contrast, clinical response in RCD2 is incomplete and prognosis is often poor. RCD (particularly RCD2) is associated with serious complications, such as ulcerative jejunitis and enteropathy-associated T-cell lymphoma (EATL). Strict clinical and laboratory criteria should be used to diagnose RCD and specialized tests for aberrancy and clonality should be interpreted in the context of their sensitivity and specificity. Adequate nutritional support and anti-inflammatory treatment may even allow patients with RCD2 to attain a clinical remission.",
keywords = "Celiac disease, gluten, immune disorder, refractory celiac disease, small intestine",
author = "Rishi, {Abdul R.} and Alberto Rubio-Tapia and Murray, {Joseph A}",
year = "2015",
month = "12",
day = "17",
doi = "10.1586/17474124.2016.1124759",
language = "English (US)",
pages = "1--10",
journal = "Expert Review of Gastroenterology and Hepatology",
issn = "1747-4124",
publisher = "Expert Reviews Ltd.",

}

TY - JOUR

T1 - Refractory celiac disease

AU - Rishi, Abdul R.

AU - Rubio-Tapia, Alberto

AU - Murray, Joseph A

PY - 2015/12/17

Y1 - 2015/12/17

N2 - Refractory celiac disease (RCD) affects patients who have failed to heal after 6–12 months of a strict gluten-free diet (GFD) and when other causes of symptoms (including malignancy) have been ruled out. It may also occur in patients who previously had responded to a long-term GFD. RCD may be categorized as RCD1 (normal immunophenotype) and RCD2 (aberrant immunophenotype). RCD1 usually responds to a continued GFD, nutritional support, and therapeutic agents such as corticosteroids. In contrast, clinical response in RCD2 is incomplete and prognosis is often poor. RCD (particularly RCD2) is associated with serious complications, such as ulcerative jejunitis and enteropathy-associated T-cell lymphoma (EATL). Strict clinical and laboratory criteria should be used to diagnose RCD and specialized tests for aberrancy and clonality should be interpreted in the context of their sensitivity and specificity. Adequate nutritional support and anti-inflammatory treatment may even allow patients with RCD2 to attain a clinical remission.

AB - Refractory celiac disease (RCD) affects patients who have failed to heal after 6–12 months of a strict gluten-free diet (GFD) and when other causes of symptoms (including malignancy) have been ruled out. It may also occur in patients who previously had responded to a long-term GFD. RCD may be categorized as RCD1 (normal immunophenotype) and RCD2 (aberrant immunophenotype). RCD1 usually responds to a continued GFD, nutritional support, and therapeutic agents such as corticosteroids. In contrast, clinical response in RCD2 is incomplete and prognosis is often poor. RCD (particularly RCD2) is associated with serious complications, such as ulcerative jejunitis and enteropathy-associated T-cell lymphoma (EATL). Strict clinical and laboratory criteria should be used to diagnose RCD and specialized tests for aberrancy and clonality should be interpreted in the context of their sensitivity and specificity. Adequate nutritional support and anti-inflammatory treatment may even allow patients with RCD2 to attain a clinical remission.

KW - Celiac disease

KW - gluten

KW - immune disorder

KW - refractory celiac disease

KW - small intestine

UR - http://www.scopus.com/inward/record.url?scp=84949789084&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84949789084&partnerID=8YFLogxK

U2 - 10.1586/17474124.2016.1124759

DO - 10.1586/17474124.2016.1124759

M3 - Article

C2 - 26603931

AN - SCOPUS:84949789084

SP - 1

EP - 10

JO - Expert Review of Gastroenterology and Hepatology

JF - Expert Review of Gastroenterology and Hepatology

SN - 1747-4124

ER -