Refractory Celiac Disease & Collagenous Sprue

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Doctors use capsule endoscopy to assess the small bowel in a number of intestinal diseases, including celiac disease. The main advantage of capsule endoscopy is that it allows for complete visualization of the intestinal mucosal surface.

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Abnormal intraepithelial lymphocytes (IELs) are the main feature of refractory celiac disease type II (RCDII). However, researchers still don't know exactly how these abnormal IELs originate. A pair of researchers recently commented on efforts to learn how these abnormal IELs might come about.

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About 40% of patients with RCDII lymphocytes develop a dangerous and invasive lymphoma. A team of researchers recently sought to identify possible origins of abnormal intraepithelial lymphocytes in refractory celiac disease type II.

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A recent, very small study indicates that tioguanine, a thiopurine derivative, offers easy, efficient treatment for refractory celiac disease, compared with current treatment regimens.

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Non-responsive celiac disease is very much what it sounds like: celiac disease where symptoms seem to resist treatment and continue even in the face of a gluten-free diet. A team of researchers recently set out to look for the most likely causes of persistent symptoms in celiac disease patients on a gluten-free diet.

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Aberrant intra-epithelial lymphocytes (IELs) are one of the major features of refractory celiac disease type II RCDII. They are categorized as pre-malignant cells, which can give rise to aggressive enteropathy-associated T cell lymphoma (EATL).

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A team of researchers recently set out to assess diagnostic yield of Vβ and Vγ clonality in refractory celiac disease (RCD). The team set out to verify whether analyzing both TCRβ and TCRγ clonality in duodenal biopsies from RCD patients improves diagnostic accuracy.

The more severe form of Refractory Celiac Disease, RCDII, might be more common in Europe than in the US.

New study on cladribine treatment for Type II Refractory celiac disease.

A new study indicates that cladribine shows excellent clinical and histological response rates, and probably less frequent transition into EATL, it looks like a promising treatment for refractory celiac disease II.

New research indicates that refractory celiac disease may be on the rise.

Researchers recently presented information at the American College of Gastroenterology that indicates that more people with celiac disease might stop responding to gluten-free diets.

New study on Mesalamine and Refractory Celiac Disease.

A recent evaluation of the safety and efficacy of small intestinal release mesalamine (SIRM) for symptom relief in refractory celiac disease (RCD) shows that SIRM seems to be a safe and effective treatment option, though larger tests are needed to know for certain.

Steroids and a GFD to Treat Collagenous Sprue

A recent study shows that most patients with collagenous sprue show a positive clinical response to a combination of gluten-free diet and steroids.

Patients with collagenous sprue typically show a severe to variably severe "flattened" mucosal biopsy lesion with distinctive sub-epithelial deposits in the lamina propria region. These deposits contain collagens, as demonstrated by both histochemical stains and ultra-structural studies.

A team of researchers recently set out to compare continual monitoring of intraepithelial lymphocyte immunophenotype and clonality against snapshot analysis in the surveillance of refractory celiac disease.

Collagenous sprue is associated with high morbidity, but the etiology of this condition is poorly understood. There is little data concerning the pathological and clinical manifestations of patients with collagenous sprue. The research team set out shed some light on the etiology, disease manifestations and outcomes of collagenous sprue.

A recent study used lactulose hydrogen-breath assays to show that small intestine bacterial overgrowth (SIBO) is likely a routine cause of non-responsive celiac disease.

Doctors from the Mayo clinic are proposing a new staging system for patients with refractory celiac disease after results of a recent study showed that their system offered greater accuracy and improved survival rates over the existing staging system. The new system will rely on the cumulative effect of 5 prognostic factors evaluated at the time of the refractory state diagnosis.

Am J Gastroenterol. 2002 Aug;97(8):2016-21 Celiac.com 01/29/2004 - According to researchers at the

Aliment Pharmacol Ther 18(5):487-494, 2003. M. S. Goerres*, J. W. R. Meijer, P. J. Wahab*, J. A. M

This article originally appeared in the Spring 2003 edition of Celiac.com's Scott-Free Newsletter.