Short report
A new cause of `non-responsiveness' in coeliac disease?
J S R Jenningsa, J I Wyattb, P D Howdlea
a St
James's University Hospital, Leeds, UK
Division of Medicine, b Department of Pathology
Correspondence to: Professor P D Howdle, Division of Medicine, Clinical Sciences Building, St James's University Hospital, Leeds LS9 7TF, UK
Submitted 29 March
1999;
Accepted 6 September 1999
A 42 year old man presented with gluten-responsive coeliac
disease and secondary pancreatic insufficiency. Subsequently his symptoms relapsed and repeat small intestinal biopsy showed villous atrophy and infiltration by leukaemic cells, despite continuation of a
gluten-free diet. Serious causes of relapse and non-responsiveness in
coeliac disease include enteropathy-associated T-cell lymphoma, ulcerative jejunitis and an end-stage hypoplastic mucosa. This is the
first report of non-responsiveness due to infiltration by leukaemia.
Keywords: coeliac disease; villous atrophy; gluten sensitivity; leukaemia
© 2000 by The Fellowship of Postgraduate Medicine
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