[Non-responsive coeliac disease: what to do?]

Area of Science:

• Gastroenterology and immunology

Background:

• Coeliac disease (CD) is a common autoimmune disorder triggered by gluten, leading to villous atrophy.
• Most CD patients improve with a strict gluten-free diet (GFD).

Observation:

• Persistent or recurring symptoms despite a GFD necessitate further investigation.
• Case studies highlight refractory coeliac disease (RCD) types I and II, and microscopic colitis as causes of non-responsive CD.
• Microscopic colitis is notably associated with CD.

Findings:

• Refractory coeliac disease (RCD) type I and II present with persistent symptoms.
• Microscopic colitis can mimic or coexist with CD, causing persistent diarrhea.
• Diagnostic workup for non-responsive CD should include evaluation for RCD and microscopic colitis.

Implications:

• Accurate diagnosis of non-responsive CD is essential for appropriate management.
• Considering RCD and microscopic colitis can lead to timely and effective treatment strategies.
• This highlights the importance of comprehensive evaluation in CD patients with persistent symptoms.