An unexpected deterrent in diagnosing refractory celiac disease and enteropathy-associated T-cell lymphoma: a gluten-free diet

Hussain, Nooreen; Hussain, Faiz; Chatterjee, Tulika; Upalakalin, J. Nalinee; Lynch, Teresa

doi:10.1080/20009666.2018.1483693

Cited by 3 publications

(4 citation statements)

References 11 publications

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“…Intestinal lymphomas are believed to be one of the leading causes of death in patients with CD diagnosed in adulthood [ 3 ]. The incidence of lymphoma is much greater in the sixth, seventh, and eighth decades of life.…”

Section: Discussionmentioning

confidence: 99%

“…Lymphomas generally follow a highly aggressive clinical course and have a poor prognosis [ 9 ]. EATLs can also present in disseminated forms with the involvement of mesenteric lymph nodes, the liver, spleen, lungs, and skin [ 3 ]. EATLs should be suspected in patients with elevated LDH and β2microglobulin, anemia, a BMI of around 18, and low serum albumin levels [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…It has been shown that 2–3% of patients with CD will develop intestinal lymphoma, of which 65% is of T-cell origin. These lymphomas are believed to be one of the leading causes of death in patients with CD diagnosed in adulthood [ 3 ]. The risk of malignancies increases in older celiac patients and is associated with both the duration of gluten exposure and age.…”

Section: Introductionmentioning

confidence: 99%

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Peripheral T-Cell Lymphoma Possibly Due to Unrecognized Celiac Disease in an Elderly Patient: A Case Report

et al. 2021

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Celiac disease (CD) is widely perceived as a childhood disorder. However, it has been demonstrated that 19–34% of new CD cases are diagnosed in patients over 60 years of age and lack the typical presentation. A 76-year-old female was admitted to the clinic due to a recurrent fever that had lasted over a year accompanied by progressive weakness, weight loss of about 10 kg, dehydration, and malnutrition. The patient had undergone resection of a fragment of the small intestine due to perforation and abscess 13 years previously (at which time no histopathological examinations were performed). During the current hospitalization, despite extensive laboratory, microbiological, and imaging tests, no specific diagnosis was made. Symptomatic treatment and empirical antibiotic therapy were conducted, but the patient died on the twenty-seventh day of hospitalization due to progressive respiratory failure. The autopsy revealed peripheral T-cell lymphoma in the mesentery of the small intestine, uterus, cecum, lung, and mediastinal lymph nodes. Based on the clinical picture, we believe that the lymphoma was induced by long-term, undiagnosed CD. Current knowledge allows us to see age-related differences in the manifestation of celiac disease and to be alert to the possible late-stage complications of the disease. The lack of awareness of how CD’s symptoms vary with age may lead to misdiagnosis and serious consequences of delayed diagnosis, including death.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Peripheral T-Cell Lymphoma Possibly Due to Unrecognized Celiac Disease in an Elderly Patient: A Case Report

et al. 2021

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“…1 It has been reported that approximately 70% of patients with CD have symptomatic remission within 2 weeks after starting a GFD. 2 Herein, this case report presents a patient with recurrent CD due to a discontinuation of GFD. When the CD recurred, the patient developed fever and pancytopaenia, and quickly died of haemophagocytic lymphohistiocytosis (HLH).…”

Section: Introductionmentioning

confidence: 99%

A fatal outcome in a patient with coeliac disease who suspended a strict gluten-free diet: a case report

Zheng

Hua

et al. 2021

J Int Med Res

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Coeliac disease (CD) is an autoimmune small bowel disease that occurs in susceptible individuals that develop an immunological reaction to gluten. A strict gluten-free diet (GFD) is the primary treatment for CD. This case report describes a patient with CD recurrence due to a discontinuation of a strict GFD by the patient. After recurrence, the patient developed fever and pancytopaenia, and quickly died of haemophagocytic lymphohistiocytosis (HLH). To the best of our knowledge, this is the first description of a case of CD associated with HLH due to discontinued GFD, which may contribute to improving the awareness of the importance of maintaining a strict GFD and having regular follow-up examinations.

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Advanced enteropathy-associated T cell lymphoma (EATL) presenting with severe malabsorption and concomitantly diagnosed coeliac disease (CD)

Rajagopal,

Thompson,

Chorzempa

et al. 2023

BMJ Case Rep

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Enteropathy-associated T cell lymphoma (EATL) is an aggressive subtype of non-Hodgkin’s lymphoma often associated with coeliac disease (CD). We describe a previously healthy man in his 50 s who presented with a history of abdominal pain, failure to thrive and significant weight loss over a 3-month period. Investigations revealed a positive coeliac serology, diffuse duodenal atrophy with multiple duodenal and jejunal ulcers on endoscopy and mesenteric lymphadenopathy on CT imaging. Duodenal tissue biopsy confirmed a diagnosis of EATL Stage IVB. Chemotherapy with cyclophosphamide, doxorubicin, vincristine and prednisone regimen was initiated. This case highlights the need for greater awareness and consideration of EATL in individuals with worsening malabsorption and abdominal pain, irrespective of coeliac history.

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An unexpected deterrent in diagnosing refractory celiac disease and enteropathy-associated T-cell lymphoma: a gluten-free diet

Cited by 3 publications

References 11 publications

Peripheral T-Cell Lymphoma Possibly Due to Unrecognized Celiac Disease in an Elderly Patient: A Case Report

Peripheral T-Cell Lymphoma Possibly Due to Unrecognized Celiac Disease in an Elderly Patient: A Case Report

A fatal outcome in a patient with coeliac disease who suspended a strict gluten-free diet: a case report

Advanced enteropathy-associated T cell lymphoma (EATL) presenting with severe malabsorption and concomitantly diagnosed coeliac disease (CD)

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