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Br Med J (Clin Res Ed). 1986 October 11; 293(6552): 908–910.
PMCID: PMC1341707

Humoral response to wheat protein in patients with coeliac disease and enteropathy associated T cell lymphoma.


Features that might distinguish uncomplicated coeliac disease from enteropathy associated T cell lymphoma were investigated. Of 76 patients with coeliac disease, 71 (93%) had raised levels of alpha gliadin antibody and all responded clinically and histologically to treatment with a gluten free diet. In contrast, none of 16 patients with enteropathy associated T cell lymphoma had raised levels of alpha gliadin antibody, and treatment with a gluten free diet resulted in histological improvement in one and transient clinical improvement in six patients. The ratio of women to men was 2.2:1 in the group with coeliac disease and 1:1.6 in the patients with enteropathy associated T cell lymphoma. Thus patients with enteropathy associated T cell lymphoma do not display a humoral immune response to wheat protein (alpha gliadin), rarely respond to a gluten free diet, and are often men. Patients with uncomplicated coeliac disease usually have raised levels of alpha gliadin antibody, always respond to a gluten free diet, and are frequently women. These findings suggest the presence of two separate forms of enteropathy: one is benign and sensitive to wheat protein whereas the other runs a malignant course.

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Selected References

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  • Cooke WT, Asquith P. Coeliac disease. Introduction and definition. Clin Gastroenterol. 1974 Jan;3(1):3–10. [PubMed]
  • Stewart JS. Clinical and morphologic response to gluten withdrawal. Clin Gastroenterol. 1974 Jan;3(1):109–126. [PubMed]
  • Isaacson P, Wright DH. Intestinal lymphoma associated with malabsorption. Lancet. 1978 Jan 14;1(8055):67–70. [PubMed]
  • Isaacson PG, O'Connor NT, Spencer J, Bevan DH, Connolly CE, Kirkham N, Pollock DJ, Wainscoat JS, Stein H, Mason DY. Malignant histiocytosis of the intestine: a T-cell lymphoma. Lancet. 1985 Sep 28;2(8457):688–691. [PubMed]
  • Loughran TP, Jr, Kadin ME, Deeg HJ. T-cell intestinal lymphoma associated with celiac sprue. Ann Intern Med. 1986 Jan;104(1):44–47. [PubMed]
  • Salter DM, Krajewski AS, Dewar AE. Immunophenotype analysis of malignant histiocytosis of the intestine. J Clin Pathol. 1986 Jan;39(1):8–15. [PMC free article] [PubMed]
  • Swinson CM, Slavin G, Coles EC, Booth CC. Coeliac disease and malignancy. Lancet. 1983 Jan 15;1(8316):111–115. [PubMed]
  • O'Farrelly C, Feighery C, Greally JF, Weir DG. Cellular response to alpha-gliadin in untreated coeliac disease. Gut. 1982 Jan;23(1):83–87. [PMC free article] [PubMed]
  • O'Farrelly C, Kelly J, Hekkens W, Bradley B, Thompson A, Feighery C, Weir DG. Alpha gliadin antibody levels: a serological test for coeliac disease. Br Med J (Clin Res Ed) 1983 Jun 25;286(6383):2007–2010. [PMC free article] [PubMed]
  • Daigneault R, Lemieux D. Evaluation of a Behring laser-nephelometer prototype in the measurement of IgG, IgA and IgM. Clin Biochem. 1978 Feb;11(1):28–31. [PubMed]
  • Terasaki PI, Bernoco D, Park MS, Ozturk G, Iwaki Y. Microdroplet testing for HLA-A, -B, -C, and -D antigens. The Phillip Levine Award Lecture. Am J Clin Pathol. 1978 Feb;69(2):103–120. [PubMed]
  • O'Farrelly C, Whelan CA, Feighery CF, Weir DG. Suppressor-cell activity in coeliac disease induced by alpha-gliadin, a dietary antigen. Lancet. 1984 Dec 8;2(8415):1305–1307. [PubMed]
  • Hourihane DO, Weir DG. Malignant celiac syndrome. Report of two cases with malabsorption and microscopic foci of intestinal lymphoma. Gastroenterology. 1970 Jul;59(1):130–139. [PubMed]
  • Slater DN, Rooney N, Bleehen S, Hamed A. The lymph node in mycosis fungoides: a light and electron microscopy and immunohistological study supporting the Langerhans' cell-retrovirus hypothesis. Histopathology. 1985 Jun;9(6):587–621. [PubMed]
  • Kieffer M, Frazier PJ, Daniels NW, Coombs RR. Wheat gliadin fractions and other cereal antigens reactive with antibodies in the sera of coeliac patients. Clin Exp Immunol. 1982 Dec;50(3):651–660. [PubMed]
  • O'Driscoll BR, Stevens FM, O'Gorman TA, Finnegan P, McWeeney JJ, Little MP, Connolly CE, McCarthy CF. HLA type of patients with coeliac disease and malignancy in the west of Ireland. Gut. 1982 Aug;23(8):662–665. [PMC free article] [PubMed]
  • Swinson CM, Hall PJ, Bedford PA, Booth CC. HLA antigens in coeliac disease associated with malignancy. Gut. 1983 Oct;24(10):925–928. [PMC free article] [PubMed]
  • Mylotte M, Egan-Mitchell B, McCarthy CF, McNicholl B. Incidence of coeliac disease in the West of Ireland. Br Med J. 1973 Mar 24;1(5855):703–705. [PMC free article] [PubMed]
  • Ansar Ahmed S, Penhale WJ, Talal N. Sex hormones, immune responses, and autoimmune diseases. Mechanisms of sex hormone action. Am J Pathol. 1985 Dec;121(3):531–551. [PubMed]

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