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[Enteropathy-associated T-cell lymphoma: a diagnostic challenge]
Victoria Busto Bea1, Laura Crespo Pérez, Miguel Ángel Rodríguez-Gandía
1Servicio de Aparato Digestivo, Hospital Universitario Ramón y Cajal, Madrid, España. victoriabusto@live.com
Insights
Diagnosing refractory celiac disease (CD) requires excluding other conditions and confirming persistent symptoms despite a gluten-free diet. A rare complication, enteropathy-associated T cell lymphoma (EATL), presents diagnostic challenges.
Area of Science:
- Gastroenterology and Immunology
- Oncology
- Clinical Diagnostics
Background:
- Refractory celiac disease (RCD) diagnosis relies on persistent symptoms and villous atrophy despite a strict gluten-free diet (GFD) for 6-12 months.
- Intraepithelial lymphocyte alterations are key diagnostic markers for RCD.
- A subset of RCD patients are at risk for developing enteropathy-associated T cell lymphoma (EATL).
Observation:
- This case study focuses on a patient with a history of silent celiac disease.
- The patient subsequently developed enteropathy-associated T cell lymphoma (EATL).
Findings:
- The diagnosis of EATL in the context of celiac disease presents significant clinical challenges.
- Early identification and management of EATL are critical for patient outcomes.
Implications:
- Highlights the need for vigilance in monitoring RCD patients for potential complications like EATL.
- Underscores the diagnostic complexities and treatment difficulties associated with EATL in celiac disease patients.
- Emphasizes the importance of understanding the progression from celiac disease to its malignant complications.
Abstract:
Diagnosis of refractory celiac disease (CD) is based on exclusion of other disorders, persistence of malabsorptive symptoms and villous atrophy, despite a strict gluten-free diet for at least 6-12 months. Detection of alterations in the intraepithelial lymphocyte population is crucial for diagnosis. A subgroup of patients with refractory CD may develop severe complications such as enteropathy-associated T cell lymphoma (EATL). We present the case of a patient with longstanding silent CD who developed EALT, highlighting the challenge posed by the diagnosis and treatment of this entity.
