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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. · Friedrich M. · Foss H.-D. · Hummel M. · Zeitz M. · Daum S.
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: 1/29/2010
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.


  

Author Contacts

PD Dr. med. Severin Daum, MD
Medical Clinic I, Gastroenterology, Rheumatology and Infectious Diseases
Charité – University Medicine Berlin, Campus Benjamin Franklin
Hindenburgdamm 30, DE–12200 Berlin (Germany)
Tel. +49 30 8445 2347, Fax +49 30 8445 4481, E-Mail severin.daum@charite.de

  

Article Information

Published online: January 29, 2010
Number of Print Pages : 4
Number of Figures : 1, Number of Tables : 1, Number of References : 17

  

Publication Details

Digestion (International Journal of Gastroenterology)

Vol. 81, No. 4, Year 2010 (Cover Date: April 2010)

Journal Editor: Beglinger C. (Basel), Göke B. (Munich)
ISSN: 0012-2823 (Print), eISSN: 1421-9867 (Online)

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


Article / Publication Details

First-Page Preview
Abstract of Case Report

Published online: 1/29/2010
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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