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    Jefferson Adams earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,000 articles on celiac disease. His coursework includes studies in biology, anatomy, medicine, science, and advanced research, and scientific methods. He previously served as Health News Examiner for Examiner.com, and devised health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

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    Scott Adams
    JAMA 2002;287:1413-1419.
    Celiac.com 04/12/2002 - According to a report published in the March 20th issue of the Journal of the American Medical Association, people with celiac disease are three times more likely to develop non-Hodgkin lymphoma (NHL) than the normal population. Dr. Carlo Catassi and colleagues from the University of Maryland in Baltimore compared the prevalence of celiac disease in 653 NHL patients with more than 5,000 healthy control subjects to determine the NHL-celiac disease occurrence rate. The results indicate that 1% of NHL patients also have celiac disease, in comparison with 0.42% of the healthy controls. Adjustments were made for age and sex, and the final results indicate that the odds ratios for a patient with celiac disease of developing NHL are: 3.1 for all types of NHL, 16.9 for gut NHL, and 19.2 for T-cell NHL. The overall risk, however, for someone with celiac disease developing NHL is only 0.63%.
    The researchers do not feel that their findings support mass screening for celiac disease, but they do feel that selected NHL patients should be screened for celiac disease. We would also like to add that these findings support the screening of people with celiac disease for NHL, which was not directly addressed by the report.

    Scott Adams
    Gut 2005;54:54-59. Celiac.com 01/20/2005 - A link between untreated celiac disease and a rare enteropathy-type T-cell lymphoma (ETTL) has been well established by several studies. According to Dr. Karin Ekstrom Smedby of the Karolinska Institute in Stockholm and colleagues, there is also an increase in the prevalence of other types of lymphomas in those with celiac disease, such as B cell and non-intestinal lymphomas. In their study the researchers reviewed and reclassified 56 cases of malignant lymphomas that occurred in 11,650 hospitalized celiac disease patients in Sweden. The observed numbers of lymphoma subtypes were compared with those expected in the Swedish population. The researchers discovered that a majority of the lymphomas were not intestinal T-cell lymphomas, but were B-cell non-Hodgkin lymphoma (NHL). In addition, 44% of the patients with B cell NHL had a history of other autoimmune/inflammatory diseases. As expected, the relative risks for T-cell NHL and primary gastrointestinal lymphomas were markedly increased. According to the researchers: "Most lymphomas complicating coeliac disease are indeed related to the disease and are not of the ETTL-type. There was a remarkable aggregation of autoimmune/inflammatory disorders, female sex, coeliac disease, and B cell lymphoma."

    Scott Adams
    Eur J Gastroenterol Hepatol 2006;18:187-194.
    Celiac.com 04/10/2006 - According to findings by Dutch researchers, celiac disease increases the risk of non-Hodgkin lymphoma—but to a lower level than once believed. Past celiac disease studies have indicated that there is a 30 to 40-fold increased risk of enteropathy-associated T-cell lymphoma, however, Dr. M. Luisa Mearin and colleagues in The Netherlands investigated the frequency of celiac disease in two large European populations—one was a control group and the other was a group of non-Hodgkin lymphoma patients—and found that 1.2% of the non-Hodgkin lymphoma patients had celiac disease compared to 0.5% of the controls. After adjusting for age and sex differences between the two groups they found that celiac disease patients had a 2.6-fold increase risk of getting non-Hodgkin lymphoma, and this increased risk was only associated with patients who had been diagnosed prior to the study, and not in those with “silent” celiac disease which was found during the study. The odds of T-cell type small bowel lymphoma in celiac disease patients was estimated to be 28 times higher than for other localizations.
    The researchers conclude that celiac disease patients have a significantly increased risk of developing non-Hodgkin lymphoma, but the association is lower than previously thought. Celiac disease is mainly associated with T-cell small bowel lymphoma which is, in general, a rare condition.

    Jefferson Adams
    Celiac.com 01/14/2009 - For decades now, doctors have known that people with celiac disease face a significantly greater risk of developing non-Hodgkin's lymphoma (NHL), though that risk has steadily declined over the last 40 years.
    Recently though, a team of doctors at the National Cancer Institute in Bethesda, Md., led by Ying Gao, M.D., has discovered that siblings of celiac patients also face an increased risk of developing NHL. Results of the study appeared in the January issue of Gastroenterology.
    The research team conducted a study using 37,869 patients with NHL, 8,323 with Hodgkin's lymphoma, and 13,842 with chronic lymphocytic leukemia who were diagnosed between 1965 and 2004. The study included 236,408 matched controls and 613,961 first-degree relatives.
    The results indicated that people with celiac disease developed NHL at rates that were 5.35 times higher than non-celiacs, but that they faced no increased risk for developing Hodgkin’s lymphoma or chronic lymphocytic leukemia.
    In some good news, the doctors found that the NHL risk level for people whose celiac disease was diagnosed between 1995 and 2004 dropped to just 3.86 times greater than for non-celiacs. This is a significant improvement over the 13.2 times greater risk of NHL faced by people diagnosed with celiac disease between 1975 and 1984.
    However, the study also showed that siblings of celiac disease patients developed NHL at rates that were more than double those of the general population (2.03).
    Clearly, as diagnosis and treatment of celiac disease has improved, the risk levels for NHL have decreased. The study underscores the need for greater vigilance on the part of both doctors and patients regarding NHL, and for greater understanding of the mechanisms that influence the development of NHL in both celiacs and non-celiacs.
    As diagnosis and treatment and monitoring of celiac disease improves, and as understanding of NHL increases, it is likely that NHL risk levels for celiac patients will drop even further. Until then, celiac patients are encouraged to stay informed, stay vigilant, and to consult with a physician to keep on top of any developments that may influence risk levels for NHL.
    Journal of Gastroenterology, January 2009; pp 91-98.


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    Thanks Posterboy, that was interesting information.  I believe that I had read something elsewhere about tetracycline, at least, being used instead of, or along with, Dapsone for severe or refractory cases of DH. Unfortunately, even if I had medical insurance (which I do not), and had a regular doctor who was even willing to recognize and accept my condition for what it is, I don't know what kind of luck I would have in persuading that hypothetical doctor to give me a particular and non-sta
    Healthysquirrel,  Please have your doctor check your Vitamin D level!   Vitamin D deficiency is related to vertigo https://www.ncbi.nlm.nih.gov/pubmed/27386060 Vitamin D can help with high IgE https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5263170/ Low vitamin D and low ferritin are tied https://www.ncbi.nlm.nih.gov/pubmed/29385099 Dry eye problems including blepharitis can be helped with vitamin d and vitamin a https://www.ncbi.nlm.nih.gov/pmc/articles
    He's still going to have to eat gluten even for an endoscopic biopsy. 2 weeks minimum. Plus guidelines say no dx on an endoscopic biopsy alone - you have to have the positive blood to go with it. Even that 2 weeks will deposit more antibodies under his skin if he's got dh.  Let me put it this way. The gut damage is the gut damage & if he's celiac & it sounds like he is but we don't have labs to prove it, then there is a treatment for it. Only 1 treatment for it. A very strict gluten
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