Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Refractory coeliac disease.

Severin Daum1, Christophe Cellier, Chris J J Mulder

  • 1Department of Medicine I, Gastroenterology, Infectious Diseases and Rheumatology, Charité, Campus Benjamin Franklin, Berlin, Germany. severin.daum@charite.de

Best Practice & Research. Clinical Gastroenterology
|June 1, 2005
PubMed
Summary
This summary is machine-generated.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Association of bowel urgency, disease activity and disability in patients with inflammatory bowel disease: A cross-sectional study from the GETAID.

Clinics and research in hepatology and gastroenterology·2026
Same author

Aberrant intra-epithelial lymphocytes cause enterocyte cell death in refractory celiac disease by CD103-β7-receptor-mediated granzyme-B degranulation which can be restored by etrolizumab.

Clinical & translational immunology·2026
Same author

Follow-up, cancer risk and mortality in Peutz-Jeghers syndrome: Data from the PRED-IdF network.

European journal of human genetics : EJHG·2026
Same author

European Society for the Study of Coeliac Disease (ESsCD) 2025 Updated Guidelines on the Diagnosis and Management of Coeliac Disease in Adults. Part 2: Management, Follow-Up, and Complex Disease Courses.

United European gastroenterology journal·2026
Same author

Association between physical activity with disease activity and functional disability in patients with inflammatory bowel disease.

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·2026
Same author

Prognostic impact of TROP2 in adenocarcinoma of the esophageal junction and stomach.

Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico·2026
Same journal

Needle-based confocal laser endomicroscopy and artificial intelligence in pancreatic cystic lesions: Insights and clinical advances.

Best practice & research. Clinical gastroenterology·2026
Same journal

Evidence-based approach to the diagnosis, management and surveillance of pancreatic cystic lesions: from the guidelines to the clinical practice.

Best practice & research. Clinical gastroenterology·2026
Same journal

Pancreatic cystic lesions in hereditary syndromes: Diagnostic role of endoscopic ultrasound.

Best practice & research. Clinical gastroenterology·2026
Same journal

Predictive risk models for the diagnosis and cancer progression of pancreatic cysts.

Best practice & research. Clinical gastroenterology·2026
Same journal

Preface.

Best practice & research. Clinical gastroenterology·2026
Same journal

Endoscopic ultrasound-guided treatment of pancreatic lesions.

Best practice & research. Clinical gastroenterology·2026
See all related articles

Refractory coeliac disease (RCD) involves persistent symptoms despite a gluten-free diet (GFD). Early diagnosis and management, potentially including immunosuppressants or chemotherapy for associated T-cell lymphomas, are crucial for improving outcomes in these complex cases.

Area of Science:

  • Gastroenterology
  • Immunology
  • Oncology

Background:

  • A subset of coeliac disease (CD) patients exhibit refractory coeliac disease (RCD), characterized by persistent symptoms and villous atrophy despite a strict gluten-free diet (GFD).
  • RCD encompasses heterogeneous conditions, some treatable with specific therapies (e.g., antibiotics, immunoglobulin), while others may necessitate immunosuppressive treatment.
  • A concerning subgroup of RCD patients may present with abnormal intraepithelial lymphocytes (IELs), suggesting early enteropathy-associated T-cell lymphoma (EATL).

Purpose of the Study:

  • To outline diagnostic and management strategies for patients with refractory coeliac disease (RCD).
  • To highlight the importance of identifying and treating potential underlying conditions, including early enteropathy-associated T-cell lymphoma (EATL), within the RCD spectrum.

Related Experiment Videos

Main Methods:

  • Review of existing literature and clinical observations regarding refractory coeliac disease (RCD) diagnosis and management.
  • Emphasis on identifying specific markers like abnormal intraepithelial lymphocyte (IEL) populations and T-cell clonality to detect early enteropathy-associated T-cell lymphoma (EATL).
  • Discussion of various therapeutic approaches, including specific treatments, immunosuppression, steroids, and emerging chemotherapies.

Main Results:

  • Refractory coeliac disease (RCD) is a complex malabsorption syndrome requiring careful differential diagnosis.
  • Early enteropathy-associated T-cell lymphoma (EATL) can be suspected in RCD patients with specific IEL abnormalities and may respond to steroid treatment.
  • While some treatments show promise, long-term outcomes for RCD remain challenging, with some patients requiring parenteral nutrition.

Conclusions:

  • Patients with refractory coeliac disease (RCD) require specialized diagnostic and therapeutic approaches.
  • Referral to tertiary centers experienced in coeliac disease is recommended for optimal management of RCD.
  • Further research into aggressive chemotherapies and cytokine use is warranted for refractory cases and associated enteropathy-associated T-cell lymphoma (EATL).