Jump to content
  • Sign Up
  • About Me

    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.

  • Related Articles

    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 08/17/2008 - One of the important ways doctors distinguish between the two types of refractory celiac disease is by looking at differences in intra-epithelial T lymphocytes (IELs) in intestinal biopsies. People with refractory celiac disease who show normal IELs are said to have refractory celiac disease I, while those with abnormal IELs are said to have refractory celiac disease II.
    A team of doctors based in the Netherlands recently set out to assess the effectiveness of computed tomography (CT) in diagnosing refractory celiac disease, and enteropathy-associated T-cell lymphoma (EATL). EATL is a generally rare, but particularly aggressive form of bowel cancer that is the leading cause of death in adults with celiac disease.
    The study team was made up of doctors Maarten Mallant, Muhammed Hadithi, Abdul-Baqi Al-Toma, Matthijs Kater, Maarten Jacobs, Radu Manoliu, Chris Mulder, and Jan Hein van Waesberghe.
    The team looked at 46 patients with clinically proven celiac disease, refractory celiac disease I, refractory celiac disease II, or EATL including 18 males and twenty-eight females. The first group contained 14 patients with uncomplicated celiac disease and 10 with type I refractory celiac disease. The second group contained 15 patients with type II refractory celiac disease and 7 patients with EATL. 5 patients from group II showed lymphandenopathy, compared to none in the first group. 20 patients from group I showed a higher number of small mesenteric vessels compared to just 11 from group II.
    This is significant because increased numbers of small mesenteric vessels are associated with an absence of refractory celiac disease II and EATL, while reduced numbers of small mesenteric vessels are associated with a higher rate of refractory celiac disease II and EATL.
    The team evaluated the two groups within eleven categories: abnormal intestinal fold patterns; bowel wall thickness, excess fluid; intestinal insussuction; ascites; lymphadenopathy; increases in lymph node numbers; mesenteric vascular changes; and spleen size. One other area the doctors found important was in differences in the average thickness of the bowel wall. Group I showed thinner bowel walls compared to group II. In group I, average bowel thickness ranged from 4mm to 11mm, with an average thickness of 7.0mm. In group II, average bowel thickness ranged from 5mm to 15mm, with an average thickness of 10.0mm. So, group II showed about 30% thicker bowel walls than group I.
    The doctors’ conclusions reaffirmed the need for a biopsy before confirming a diagnosis of celiac disease. Regarding the use of CT, the team found CT unnecessary for cases of uncomplicated celiac disease, but found CT very useful in cases of complicated and pre-cancerous celiac disease.
    The study team also found that pattern reversal and/or loss of jejunal folds is specific to celiac disease, though they had an admittedly small sample of just 24 of their 46 patients, so their measures are far from definitive.
    All of this drives home the importance of encouraging early and accurate screening for celiac disease. Ideally, we will get to the point where, like many European countries, we will begin to catch celiac disease before it ever becomes refractory, and before it ever develops into EATL.
    Until then, stay informed and take an active role in maintaining your own health.
    World J Gastroenterol 2007; 13(11): 1696-1700


  • Popular Contributors

  • Forum Discussions

    Well, TDZ, I certainly hope that your husband is able to get some Dapsone to quickly ameliorate his DH (and that it does not have too many adverse effects on him, either).  It sounds like your husband's DH is worse than mine ever was, so I can only imagine the ongoing agony that he's been dealing with.  To call DH "just an itch" would be like calling am amputation "just a scratch", i.e., probably nobody who has not experienced it can imagine how frustrating, distracting, maddening and depre
    Yeah, I think the only reason to bother with trying to get a diagnosis is if it's needed in order to get the Dapsone, which would be a lifesaver for him in stopping or helping the itching while he gets his diet more in order. He's had continuous rash and lesions and blisters over large to larger parts of his body for a couple of years, and the itching is driving him insane.  We do have an appointment with his PCP this afternoon, to try and talk him into trying the Dapsone -- seems it would
    Alaskaguy,  Sorry to interrupt, but I wanted to put in my two cents. I prefer the Autoimmune Protocol diet because it helps heal the gut so quickly.  It's a bit more strict than the Fasano diet but the results are striking.   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5647120/#!po=43.7500 People with Celiac and DH have a problem with leaky guts.  The AIP diet helps heal this problem. https://www.ncbi.nlm.nih.gov/pubmed/3934051 Nightshade vegetables are not allowed
×
×
  • Create New...