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Large Granular Lymphocytic Leukemia: A Treatable Form of Refractory Celiac Disease
- Source :
- Gastroenterology. 143:1470-1472.e2
- Publication Year :
- 2012
- Publisher :
- Elsevier BV, 2012.
-
Abstract
- Large granular lymphocyte leukemia (LGL) is characterized by clonal expansion of CD3+ T cells or CD3(-) natural killer cells and frequently is associated with autoimmune diseases. We describe 2 patients with celiac disease who no longer responded to gluten-free diets after they developed T-cell LGL, with intestinal localization of malignant lymphocytes. Flow cytometry phenotyping of isolated intestinal intraepithelial and lamina propria cells eliminated type II refractory celiac disease, identifying large-sized CD8(+)CD57(+) T cells. Treatment with a combination of cyclosporine and methotrexate restored the patients' sensitivity to gluten-free diets. LGL therefore might be a cause of refractory celiac disease that is sensitive to immunosuppressive therapy.
- Subjects :
- Pathology
medicine.medical_specialty
Large granular lymphocytic leukemia
CD3
chemical and pharmacologic phenomena
Lymphocyte proliferation
Biology
Diet, Gluten-Free
medicine
Humans
Treatment Failure
Aged
Lamina propria
Hepatology
Gastroenterology
nutritional and metabolic diseases
Middle Aged
medicine.disease
digestive system diseases
Leukemia, Large Granular Lymphocytic
Celiac Disease
Methotrexate
Treatment Outcome
medicine.anatomical_structure
Peripheral blood lymphocyte
Immunology
Cyclosporine
biology.protein
Intraepithelial lymphocyte
Drug Therapy, Combination
Female
Immunosuppressive Agents
CD8
medicine.drug
Subjects
Details
- ISSN :
- 00165085
- Volume :
- 143
- Database :
- OpenAIRE
- Journal :
- Gastroenterology
- Accession number :
- edsair.doi.dedup.....d8b577828d1ca4774d0c205096eac4a6