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Table of Contents
Vol. 81, No. 4, 2010
Issue release date: April 2010
Section title: Case Report
Digestion 2010;81:231–234
(DOI:10.1159/000269810)

Immune Modulation by Non-Hodgkin Lymphoma in a Patient with Two Primary Intestinal T-Cell Lymphomas and Long-Standing Celiac Disease

Mühr-Wilkenshoff F.a · Friedrich M.a · Foss H.-D.b · Hummel M.b · Zeitz M.a · Daum S.a
aMedical Clinic I, Gastroenterology, Rheumatology and Infectious Diseases, and bDepartment of Pathology, Charité – University Medicine Berlin, Campus Benjamin Franklin, Berlin, Germany

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Article / Publication Details

First-Page Preview
Abstract of Case Report

Published online: January 29, 2010
Issue release date: April 2010

Number of Print Pages: 4
Number of Figures: 1
Number of Tables: 1

ISSN: 0012-2823 (Print)
eISSN: 1421-9867 (Online)

For additional information: http://www.karger.com/DIG

Abstract

Tumors may influence immunologic reactions. Here, we report on a 72-year-old patient who suffered from celiac disease (CD) that had been diagnosed 20 years before. Under a normal diet but without any evidence of enteropathy or CD-associated antibodies, the patient developed a jejunal T-cell lymphoma. It was resected due to perforation and four courses of IMVP-16 were added. The patient started and kept a strict gluten-free diet (GFD). Two years later, he presented with weight loss and a clonally divergent refractory sprue type II with loss of antigen (CD8; T-cell receptor-β) expression in intraepithelial lymphocytes. At this time point, he showed high titers of CD-associated antibodies, although he was on a strict GFD. This case report highlights several questions: the missing enteropathy under a gluten-containing diet supports the notion of immune suppression in malignant diseases, especially non-Hodgkin lymphoma. Secondly, the patient developed an early form of a second independent T-cell lymphoma (refractory sprue type II) under a strict GFD, then with CD-associated antibodies, which raises the question whether the clonal intraepithelial lymphocytes were stimulating antibody production. Thus, the single detection of CD-associated antibodies in patients with CD is not itself proof of noncompliance with GFD.

© 2010 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Case Report

Published online: January 29, 2010
Issue release date: April 2010

Number of Print Pages: 4
Number of Figures: 1
Number of Tables: 1

ISSN: 0012-2823 (Print)
eISSN: 1421-9867 (Online)

For additional information: http://www.karger.com/DIG


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Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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