NEW YORK, July 17 (Praxis Press) The cellular abnormalities and long-term prognosis of refractory sprue are largely unknown. Cellier and colleagues studied the phenotypic and molecular features of intraepithelial T cells in patients with refractory sprue (see paper). Analysis of intestinal tissue revealed an aberrant intraepithelial lymphoid population and T-cell receptor gene rearrangements in most patients. Patients with aberrant lymphocytes had a poorer prognosis, and some developed overt T-cell lymphoma; patients without aberrant lymphocytes made a full recovery. Refractory sprue with aberrant lymphocytes may represent the link between coeliac disease and enteropathy-associated T-cell lymphoma.

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