ArticleGut2003
Refractory coeliac sprue is a diffuse gastrointestinal disease.
Article in Gut, 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.
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Who cites it
30 citing papers in PubMed, 1 synthesis or guideline pooled it, 163 citations in OpenAlex.
- Colonic neoplasia and celiac disease: A systematic review.World journal of gastroenterology · 2025Pooled it
- Refractory Celiac Disease: Nutritional Failure, Immune Dysregulation, and Lymphomagenesis.Nutrients · 2026Review
- Liver Involvement in Celiac Disease and Immune-Mediated Diseases of the Small Bowel.Liver international : official journal of the International Association for the Study of the Liver · 2025Review
- Refractory Celiac Disease: What the Gastroenterologist Should Know.International journal of molecular sciences · 2024Review
- Extranodal T- and NK-cell lymphomas.Virchows Archiv : an international journal of pathology · 2023Review
- Refractory celiac disease and its mimickers: a review on pathogenesis, clinical-pathological features and therapeutic challenges.Frontiers in oncology · 2023Review
- Review
- Article
- Review
- Enteropathy-Associated T cell Lymphoma.Current hematologic malignancy reports · 2021Review
- Refractory Celiac Disease.Current gastroenterology reports · 2020Review
- Refractory Celiac Disease Type II: A Case Report and Literature Review.Frontiers in medicine · 2020Article
- Pathogenesis of Enteropathy-Associated T Cell Lymphoma.Current hematologic malignancy reports · 2018Review
- Enteropathy-Associated T-Cell Lymphoma.Current hematologic malignancy reports · 2016Review
- A 37-year-old woman with refractory coeliac disease type II disease treated by stem cell transplantation.BMJ case reports · 2015Article
- Article
- Enteropathy associated T cell lymphoma in celiac disease: a large retrospective study.Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver · 2013Article
- Indolent small intestinal CD4+ T-cell lymphoma is a distinct entity with unique biologic and clinical features.PloS one · 2013Article
- Refractory celiac disease: from bench to bedside.Seminars in immunopathology · 2012Review
- Refractory lymphocytic enterocolitis and tumor necrosis factor antagonist therapy.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2010Article
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Authors and funding
11 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRefractory coeliac sprue (RCS) with an immunophenotypically aberrant clonal intraepithelial lymphocyte (IEL) population is considered a cryptic form of intestinal T cell lymphoma.
aimsTo investigate the distribution of the abnormal and monoclonal IEL population in the digestive tract of RCS patients. PATIENTS AND
methodsWe compared the frequency of lymphocytic gastritis (LG) and lymphocytic colitis (LC), together with IEL phenotype and T cell clonality, in gastric and colonic samples from 15 adults with RCS (all with aberrant CD3 intracytoplasmic(+) surface(-) CD8(-) clonal IELs on duodenojejunal biopsies), 18 patients with active coeliac disease (ACD), and 10 patients with coeliac disease (CD) on a gluten free diet (GFD-CD) by means of immunohistochemistry and multiplex polymerase chain reaction amplification of the T cell receptor gamma gene (TCR-gamma) rearrangement. Blood samples of nine RCS patients were also tested for clonality.
resultsLG was found in 9/14 (64%), 11/18 (61%), and 3/10 (30%) patients with RCS, ACD, and GFD-CD, respectively, while LC was found in 6/11 (55%), 3/4 (75%), and 2/3 (66%) patients. Contrary to CD, all samples from patients with LG and LC showed an aberrant IEL phenotype. Monoclonal TCR-gamma rearrangements were detected in 8/13 (62%), 8/10 (80%), and 4/9 (44%) of gastric, colonic, and blood samples, respectively, from RCS patients, while in CD patients such rearrangements were only found in 2/25 (8%) gastric samples.
conclusionThe immunophenotypically aberrant monoclonal IEL population present in the small intestine of patients with RCS frequently disseminates to the blood and the entire gastrointestinal epithelium, suggesting that this is a diffuse gastrointestinal disease.
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