Malamut Georgia, Murray Joseph A, Cellier Christophe
Université Paris Descartes, Paris, France.
Gastrointest Endosc Clin N Am. 2012 Oct;22(4):759-72. doi: 10.1016/j.giec.2012.07.007. Epub 2012 Aug 24.
A small subset of patients with celiac disease become refractory to a gluten-free diet, with persistent or recurrent symptoms of malabsorption and intestinal villous atrophy. This condition, defined as refractory celiac disease (RCD), is diagnosed after other small bowel diseases with villous atrophy are excluded. RCD is subdivided into 2 subgroups: type I RCD and type II RCD (RCDII). This latter condition is considered a low-grade intraepithelial lymphoma and has a poor prognosis. This article reviews the clinical and pathologic features of RCD and recent pathogenic findings in RCDII, offering a model to study how inflammation can drive T-cell lymphomagenesis.
一小部分乳糜泻患者对无麸质饮食产生耐受不良，出现持续或反复的吸收不良症状以及肠绒毛萎缩。这种情况被定义为难治性乳糜泻（RCD），在排除其他伴有绒毛萎缩的小肠疾病后得以诊断。RCD可细分为两个亚组：I型RCD和II型RCD（RCDII）。后一种情况被认为是一种低级别上皮内淋巴瘤，预后较差。本文综述了RCD的临床和病理特征以及RCDII最近的发病机制研究结果，提供了一个研究炎症如何驱动T细胞淋巴瘤发生的模型。
