Christopher Hammerle, MD, and Sheila Crowe, MD, from the University of Virginia of Charlottesville, gave a presentation of their recent findings on a retrospective analysis of refractory celiac disease at the 75th Annual American College of Gastroenterology meeting in San Antonio. Results of the study, reported in Medpage Today, suggest that an increasing number of celiac patients may no longer be responding to a gluten-free diet. In the study, 17 gluten-free diet nonresponsive (refractive) patients were identified among the celiac patients treated at the University of Virginia Medical Center during the last 10 years. Interestingly, among the 17 refractive patients, 16 were diagnosed within the last 5 years, with 41% diagnosed within the last 6 months. Additionally, 5 had concomitant autoimmune disease and the average time to diagnosis of refractive disease was 4.7 years after the initial diagnosis of celiac disease. For each patient, noncompliance with the gluten-free diet was eliminated as the cause of refractive disease. The findings of this limited single-site study suggest that the incidence of refractory celiac disease is increasing. However, accidental ingestion from contaminated gluten-free grains or other products cannot be entirely ruled out.
Primary source: American College of Gastroenterology
Hammerle C, Crowe S "Natural history and treatment of refractory celiac disease: Experience with 17 patients at a single center" ACG 2010; Abstract 235.