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Lymphocytic enterocolitis in patients with 'refractory sprue'.
R N DuBois1, A J Lazenby, J H Yardley
1Department of Internal Medicine, Johns Hopkins University, School of Medicine, Baltimore, MD.
JAMA
|August 18, 1989
Summary
This study explores the link between celiac disease and lymphocytic colitis. Some patients with celiac disease also show microscopic colitis, suggesting a potential panintestinal disorder.
Area of Science:
- Gastroenterology
- Pathology
Background:
- Celiac disease is an autoimmune disorder triggered by gluten, primarily affecting the small intestine.
- Lymphocytic colitis is an inflammatory condition of the colon characterized by increased intraepithelial lymphocytes.
Observation:
- A patient with refractory sprue and malabsorption also presented with lymphocytic colitis.
- Examination of patients with celiac disease revealed colonic biopsy findings consistent with lymphocytic colitis in a subset.
- Three patients with both small bowel and colonic inflammation unresponsive to a gluten-free diet were identified.
Findings:
- A significant association was observed between celiac disease and lymphocytic colitis.
- No cases of collagenous colitis were found in conjunction with celiac disease.
- A distinct entity, termed lymphocytic enterocolitis with malabsorption, is proposed for patients with panintestinal inflammation unresponsive to a gluten-free diet.
Implications:
- These findings suggest a potential overlap or shared etiology between celiac disease and lymphocytic colitis.
- The proposed 'lymphocytic enterocolitis' may represent a distinct clinical entity requiring specific diagnostic and therapeutic approaches.
- Further research is warranted to elucidate the pathogenesis and clinical significance of this panintestinal inflammatory condition.