Lymphoma Risk Up in Celiac Disease
Published: Aug 5, 2013 | Updated: Aug 6, 2013, By Nancy Walsh, Staff Writer, MedPage Today
Reviewed by F. Perry Wilson, MD, MSCE; Instructor of Medicine, Perelman School of Medicine at the University of Pennsylvania and Dorothy Caputo, MA, BSN, RN, Nurse Planner
Patients with celiac disease have an elevated risk for lymphoproliferative malignancies, particularly if they have persistent villous atrophy, a population-based cohort study found.
Compared with the general population, the standardized incidence ratio for lymphoproliferative malignancy among patients with celiac disease was 2.81 (95% CI 2.10-3.67), according to Benjamin Lebwohl, MD, of Columbia University in New York, and colleagues. And for those who continued to have villous atrophy of the intestinal mucosa, the standardized incidence ratio was 3.78 (95% CI 2.71-5.12), the researchers reported in the August 6 issue of Annals of Internal Medicine.
Previous studies have suggested that patients with celiac disease are atincreased risk for lymphomas, and although the precise reason for this isn't clear, it may relate to ongoing villous atrophy in some patients, particularly those who fail to adhere to a gluten-free diet.
Because current guidelines don't clarify whether patients should have a follow-up biopsy to confirm mucosal healing, and to estimate the risk for malignancy among those with persistent villous atrophy, Lebwohl and colleagues analyzed data and biopsy reports from Sweden's pathology departments for the years 1969 to 2008.