International Journal of Celiac Disease
ISSN (Print): 2334-3427 ISSN (Online): 2334-3486 Website: http://www.sciepub.com/journal/ijcd Editor-in-chief: Samasca Gabriel
Open Access
Journal Browser
Go
International Journal of Celiac Disease. 2015, 3(1), 40-43
DOI: 10.12691/ijcd-3-1-3
Open AccessArticle

Complete Resolution of Type 1 Refractory Celiac Disease after Combined Treatment with Budesonide and Azathioprine: A Case Report and Literature Review

Juan Sebastian Lasa1,

1Gastroenterology Section, Internal Medicine Department, Centro de Educación Médica e Investigación Clínica (CEMIC), Buenos Aires, Argentina

Pub. Date: January 11, 2015

Cite this paper:
Juan Sebastian Lasa. Complete Resolution of Type 1 Refractory Celiac Disease after Combined Treatment with Budesonide and Azathioprine: A Case Report and Literature Review. International Journal of Celiac Disease. 2015; 3(1):40-43. doi: 10.12691/ijcd-3-1-3

Abstract

Refractory Celiac Disease is a rare condition associated with a substancial mortality rate. Both treatment and follow-up are still matter of debate. The case of a 54 year-old man with refractory celiac disease is presented who required treatment with both budesonide and azathioprine. A concise review of the clinical Management of Refractory Celiac Disease is then performed.

Keywords:
celiac disease diet gluten free lymphoma

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]  Di Sabatino A, Corazza GR. Coeliac disease. Lancet 2009; 373: 11480-93.
 
[2]  Murray JA, Watson T, Clearman B, Mitros F. Effect of a gluten-free dieron gastrointestinal symptoms in celiac disease. Am J Clin Nutr 2004; 79: 669-73.
 
[3]  Daum S, Cellier C, Mulder CJ. Refractory coeliac disease. Best Pract Res Clin Gastroenterol 2005; 19: 413-24.
 
[4]  Rubio-Tapia A, Murray JA. Classification and Management of refractory celiac disease. Gut 2010; 59:547-57.
 
[5]  Al-Toma A, Verbeek WH, Hadithi M, von Blomberg BM, Mulder CJ. Survival in refractory coeliac disease and enteropathy-associated T-cell lymphoma: retrospective evaluation of single-centre experience. Gut 2007; 56: 1373-8.
 
[6]  Malamut G, Afchain P, Verkarre V, Lecomte T, Amiot A, Damotte D, Bouhnik Y, Colombel JF, Delchier JC, Allez M, Cosnes J, Lavergne-Slove A, Meresse B, Trinquart L, MacIntyre E, Radford-Weiss I, Hermine O, Brousse N, Cerf-Bensussan N, Cellier C. Presentation and long-term follow up of refractory celiac disease: comparison of type I with type II. Gastroenterology 2009; 136: 81-90.
 
[7]  Al-Toma A, Verbeek WH, Mulder CJ. Update on the Management of refractory coeliac disease. J Gastrointestin Liver Dis 2007; 16: 57-63.
 
[8]  Ashton-Key M, Diss T, Pan L, Du MQ, Isaacson PG. Molecular analysis of T-cell clonality in ulcerative jejunitis and enteropathy-associated T-cell lymphoma. Am J Pathol 1997; 151: 493-98.
 
[9]  Al-Toma A, Goerres MS, Meijer JW, von Blomberg BM, Wahab PJ, Kerckhaert JA, Mulder CJ. Cladribine therapy in refractory celiac disease with aberrant T cells. Clin Gastroenterol Hepatol. 2006; 4: 1322-7.
 
[10]  Tack GJ, Verbeek WH, Al-Toma A, Kuik DJ, Schreurs MW, Visser O, Mulder CJ. Evaluation of cladribine treatment in refractory celiac disease type II. World J Gastroenterol 2011; 17: 506-513.
 
[11]  Al-Toma A, Visser OJ, van Roessel HM, von Blomberg BM, Verbeek WH, Scholten PE, Ossenkoppele GJ, Huijgens PC, Mulder CJ. Autologous hematopoietic stem cell transplantation in refractory celiac disease with aberrant T cells. Blood 2007; 109: 2243-49.
 
[12]  Daum S, Ipczynski R, Heine B, Schulzke JD, Zeitz M, Ullrich R. Therapy with budesonide in patients with refractory sprue. Digestion. 2006; 73: 60-8.
 
[13]  Brar P, Lee S, Lewis S, Egbuna I, Bhagat G, Green PH. Budesonide in the treatment of refractory celiac disease. Am J Gastroenterol. 2007; 102: 2265-9.
 
[14]  Rubio-Tapia A, Kelly DG, Lahr BD, Dogan A, Wu TT, Murray JA. Clinical staging and survival in refractory celiac disease: a single center experience. Gastroenterology. 2009; 136:99-107.
 
[15]  Mauriño E, Niveloni S, Cherñavsky A, Pedreira S, Mazure R, Vazquez H, Reyes H, Fiorini A, Smecuol E, Cabanne A, Capucchio M, Kogan Z, Bai JC. Azathioprine in refractory sprue: results from a prospective, open-label study. Am J Gastroenterol 2002 Oct; 97(10): 2595-60.
 
[16]  Goerres MS, Meijer JW, Wahab PJ, Kerckhaert JA, Groenen PJ, Van Krieken JH, Mulder CJ. Azathioprine and prednisone combination therapy in refractory coeliac disease. Aliment Pharmacol Ther. 2003; 18: 487-94.
 
[17]  Connell WR, Kamm MA, Dickson M, Balkwill AM, Ritchie JK, Lennard-Jones JE. Long-term neoplasia risk after azathioprine treatment in inflammatory bowel disease. Lancet. 1994; 343: 1249-52.
 
[18]  Herrinton LJ, Liu L, Weng X, Lewis JD, Hutfless S, Allison JE. Role of thiopurine and anti-TNF therapy in lymphoma in inflammatory bowel disease. Am J Gastroenterol. 2011 Dec; 106(12): 2146-53.