Original treatments, including corticosteroids, azathioprine, infliximab, ciclosporin, and interleukin 10 have been occasionally reported in refractory sprue patients with unsatisfactory results.^1–8 We report on the clinical and histological efficacy of anti-T chemotherapy (pentostatine) in a patient with a refractory sprue complicated by an ulcerative and stenotic jejunitis.

A 38 year old man diagnosed with refractory sprue in June 2002 developed ulcerative jejunitis in July 2003. Diagnosis led on the following: malabsorptive diarrhoea resistant to a gluten free diet (GFD); severe malnutrition (body mass index (BMI) 14.3 kg/m²); albuminaemia 11 g/l; diffuse total villous atrophy associated with jejunal ulcerations and a major intestinal intraepithelial CD3+ CD8− T lymphocyte population (IEL) (fig 1A–C); clonal T cell receptor γ rearrangement; negative circulating antigliadin and antitransglutaminase IgA and IgG antibodies (total IgA and IgG were normal); hyposplenism; …