International Journal of Celiac Disease, 2018, Vol. 6, No. 2, 47-48
Available online at http://pubs.sciepub.com/ijcd/6/2/7
©Science and Education Publishing
DOI:10.12691/ijcd-6-2-7
Celiac Disease & Lymphoproliferative Malignancy
at Adulthood
Hakim Rahmoune
1,2,*
, Nada Boutrid
1,2
, Mounira Amrane
2,3
, Soraya Ouhida
2,4
,
Djamel Abdellouche
4
, Belkacem Bioud
1,2
1
Department of Pediatrics, University Hospital of Setif, Setif 1 University, Algeria
2
Genetic, Cardiovascular & Nutritional Diseases Laboratory, Setif-1 University, Algeria
3
Laboratory, CAC-Setif, Setif 1 University, Algeria
4
Department of Pathological Anatomy, University Hospital of Setif, Setif 1 University, Algeria
*Corresponding author: rahmounehakim@gmail.com
Abstract Celiac disease (CD) is associated with an increased risk for malignancy, specially lymphoproliferative.
During a retrospective annual study of intestinal biopsies results in the pathology department at the University
Hospital of Setif, we were only half surprised to find a lymphoma in an adult patient initially presenting a CD.
We briefly present this case with a review of the current literature.
Keywords: celiac disease, lymphoproliferative malignancy, gastrointestinal cancers
Cite This Article: Hakim Rahmoune, Nada Boutrid, Mounira Amrane, Soraya Ouhida, Djamel Abdellouche,
and Belkacem Bioud, “Celiac Disease & Lymphoproliferative Malignancy at Adulthood.” International Journal
of Celiac Disease, vol. 6, no. 2 (2018): 47-48. doi: 10.12691/ijcd-6-2-7.
1. Introduction
Celiac disease (CD) is an auto-immune disease triggered
by dietary exposure to gluten in genetically susceptible
population (carrying HLA-DQ2 Or HLA-DQ8) [1].
CD in adulthood depicts a higher frequency extra_intestinal
manifestations as well as many associations with other
immune mediated diseases and malignanciers. Particularly,
CD is associated with an increased risk for lymphoproliferative
malignancy, while other types of malignancies are sparsely
reported [2,3].
2. Material and Method
We made a retrospective study of the reports of
intestinal biopsies in celiac patients in the University
Hospital of Setif.
Thus, a group of interns in medicine collected the
histological reports of these biopsies at the department of
pathology during the year 2016 (from January 1
st
to
December 31
st
, 2016).
We analyzed various data including the different
associated lesions in celiac population.
3. Results
We collected fifty nine (59) reports of both adult and
pediatric celiac patients (32 adults and 17 children).
We found one patient (1.7% of the total reports) that
associated celiac disease and intestinal (small bowel) lymphoma.
Further information about this case (a female patient,
41 years old) could not been obtained (anonymous data).
4. Discussion
Evidence, including population-based studies, confirmed
that patients with diagnosed CD are at increased risk of
malignancy and mortality [4,5].
Notably, patients with CD have an increased risk of
lympho-proliferative malignancy and gastrointestinal
cancer; and enteropathy-associated T cell lymphoma may
occur in a subgroup of patients with refractory CD [6,7].
Inversely, reduced IgA and IgG levels lead to a lower
detection rate of serological screening for CD in patients
with a history of lymphoma [8].
A recent meta-analysis found that CD was particularly
associated with an overall increased risk of gastro-intestinal
malignancies like esophageal cancer and small intestinal
carcinoma [9].
Persistent villous atrophy during CD compared with
mucosal healing was associated with an increased risk for
lymphoproliferative neoplasms [10].
In such cases of complicated CD, enteroscopy (wireless
or wired) is considered as an efficient diagnostic tool for
the detection of malignant and premalignant lesions of the
small bowel [11,12].
At the opposite, some evidence suggests that a gluten
free diet could reduce the risk of lymphoproliferative
malignancy, and even reduces the overall risk of mortality
[4].
As mentioned before, in addition to digestive neoplasms,
CD patients present also a higher risk to develop other
malignancies like [13,14,15].