Abstract

GIL-GULIAS, Lorraine; SIERRA-SANTOS, Lucía; BRAVO-LIZCANO, Ruth  and  MORENO-CABALLERO, Bárbara. Refractory celiac disease: when a gluten-free diet does not heal. Rev Clin Med Fam [online]. 2016, vol.9, n.2, pp.110-113. ISSN 2386-8201.

We present the case of a 61-year-old woman with celiac disease since age 21, who starts 12 months ago with intermittent postprandial epigastralgia, altered bowel habit and weight loss. The patient affirms the strict observance of the gluten and lactose free diet, which is confirmed by negative antibody titration analysis. Due to these symptoms, a gastroscopy is performed in which an atrophy of the villous architecture is detected. A Marsh grade III mucosa damage is also found in the biopsy, being diagnosed of refractory celiac disease (RCD). RCD is a rare entity present in 5-8% of all celiac patients diagnosed in adulthood; it produces an increased risk of intestinal T-cell lymphoma, this is why it is important to know and suspect this disease.

Keywords : Celiac disease; Gluten; Enteropathy-associated T-cell lymphoma.

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