Abstract:
BACKGROUND:Refractory sprue with malabsorption carries a risk of lymphoma. AIM:To examine whether a good clinical but poor histological response during a strict gluten-free diet predicts a poor outcome. METHODS:The study involved all coeliac patients who showed no histological recovery within 2 years on a strict gluten-free diet. Small intestinal biopsy and bone mineral density were investigated in 2001 and clinical features were followed up until 2005. The results were compared to those in 18 coeliac patients with a good histological recovery. RESULTS:Thirteen coeliac patients had persistent small intestinal villous atrophy despite maintaining gluten-free diet. All had demonstrated a good clinical response. Osteoporosis was found in 58% and 22% of the non-responders and responders, respectively (P = 0.04). In 2005, two of the non-responders had developed symptomatic refractory sprue, one died of lymphoma and one of carcinoid tumour, and one gastric adenocarcinoma was operated. None of the 18 controls had developed refractory sprue or malignancy. The frequency of histological non-responsive disease was 1.9%. CONCLUSIONS:Persistent villous atrophy in adult coeliac disease, even in the absence of symptoms, carries a risk of subsequent severe complications. The follow-up biopsy is important in detecting these individuals.
journal_name
Aliment Pharmacol Therjournal_title
Alimentary pharmacology & therapeuticsauthors
Kaukinen K,Peräaho M,Lindfors K,Partanen J,Woolley N,Pikkarainen P,Karvonen AL,Laasanen T,Sievänen H,Mäki M,Collin Pdoi
10.1111/j.1365-2036.2007.03311.xsubject
Has Abstractpub_date
2007-05-15 00:00:00pages
1237-45issue
10eissn
0269-2813issn
1365-2036pii
APT3311journal_volume
25pub_type
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journal_title:Alimentary pharmacology & therapeutics
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abstract:BACKGROUND:Helicobacter pylori infection elicits persistent neutrophil infiltration in gastric mucosa. The expression of cyclooxygenase (COX)-2 and inhibition of apoptosis in the neutrophils could contribute to the pathogenesis of H. pylori infection. Rebamipide, a mucosal protective and ulcer-healing drug, has been kn...
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journal_title:Alimentary pharmacology & therapeutics
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