From the Guidelines
Patients with untreated celiac disease are at increased risk for lymphoma. This is a well-established complication of the disease, as highlighted in a systematic review and recommendations for clinical trials published in the journal Gut in 2018 1. The study notes that untreated coeliac disease carries an increased risk of intestinal and extraintestinal malignancy, particularly lymphoma. This increased risk is a significant concern, as lymphoma can have severe consequences on morbidity, mortality, and quality of life.
When considering the options provided, it is essential to prioritize the most accurate and evidence-based information. Option A is supported by the study, which emphasizes the increased risk of lymphoma in patients with untreated celiac disease 1. In contrast, options B, C, and D are not directly addressed in the provided evidence, and option E, while potentially relevant, is not the most critical concern in this context.
Key points to consider:
- Untreated celiac disease increases the risk of lymphoma and other malignancies
- The risk of lymphoma is a significant concern for patients with untreated celiac disease
- A strict gluten-free diet is essential for managing celiac disease and reducing the risk of complications, including lymphoma
- Regular monitoring and follow-up are crucial for patients with celiac disease to ensure early detection and management of potential complications.
From the Research
Celiac Disease Complications
- Patients with untreated celiac disease are at increased risk for lymphoma, as shown in studies 2, 3, 4, 5.
- The risk of developing lymphoma and other malignancies is increased in celiac disease, especially if initially diagnosed in the elderly, or late in the clinical course of the disease 2.
- Celiac disease is associated with an increased risk for non-Hodgkin lymphoma, especially of T-cell type and primarily localized in the gut 3, 4.
- The risk of lymphoproliferative malignancy in patients with celiac disease is dependent on small intestinal histopathology, with no increased risk in latent celiac disease 6.
Associated Conditions
- There is no evidence to suggest that patients with type 2 diabetes are considered to be at increased risk for celiac disease based on the provided studies.
- The most commonly associated skin condition is not specified in the provided studies, but epidermolysis bullosa is not mentioned as a commonly associated condition.
- Patients with latent celiac disease (positive IgA endomysial antibody, but normal small bowel biopsy) do not have an increased risk of lymphoproliferative malignancy 6, but it is not specified whether they should be on a gluten-free diet.
Testing and Treatment
- There is no evidence to suggest that patients without symptoms should be tested for thiamine deficiency based on the provided studies.