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Effect of a Gluten-free Diet on the Risk of Enteropathy-associated T-cell Lymphoma in Celiac Disease

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Abstract

Patients with celiac disease have an increased rate of enteropathy-associated T-cell lymphoma, but conflicting data are available about the protective role of a gluten-free diet with regard to the development of this malignancy. We followed 1,757 celiac patients for a total period of 31,801 person-years, collecting data about the frequency of gluten intake and the incidence of the enteropathy-associated T-cell lymphoma. Out of the nine celiac patients who developed an intestinal lymphoma [standard morbidity ratio of 6.42 (95% CI = 2.9–12.2; P < 0.001)], only two kept a strict gluten-free diet after the diagnosis of celiac diasese and developed the malignancy after the peridiagnosis period of 3 years, dropping therefore the standard morbidity ratio to 0.22 (95%CI = 0.02–0.88; P < 0.001). The risk of developing an intestinal lymphoma for the celiac patients that used to have dietary gluten was significant (X2 = 4.8 P = 0.01). These results show that a strict gluten-free diet is protective towards the development of enteropathy-associated T-cell lymphoma.

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Authors and Affiliations

  1. Division of Food Science, Human Nutrition and Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy

    Marco Silano & Massimo De Vincenzi

  2. Department of Internal Medicine, S. Orsola-Malpighi Hospital, Bologna, Italy

    Umberto Volta

  3. Fatebenefratelli Hospital, Rome, Italy

    Alessandro De Vincenzi

  4. Department of Laboratory Medicine, University Hospital Tor Vergata, Rome, Italy

    Mariarita Dessì

Authors
  1. Marco Silano
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  2. Umberto Volta
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  3. Alessandro De Vincenzi
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  4. Mariarita Dessì
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  5. Massimo De Vincenzi
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Consortia

The Collaborating Centers of the Italian Registry of the Complications of Coeliac Disease

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Correspondence to Marco Silano.

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Collaborating Centers

Cattedra di Medicina Interna II, Univ. Cattolica, Roma, G.Gasbarrini, M.D., V. De Vitis, M.D.; Dipartimento di Pediatria, Univ. Federico II, Napoli, L. Greco, M.D., S. Auricchio, M.D.; Ospedale per gli infermi di Faenza-Azienda USL di Ravenna, D.Santini, M.D., F. Scaggiante M., M.D., Vincenzi M., Federici M.D.; Istituto Giannina Gaslini, Pediatria III, Genova, E. Castellano, M.D., A.Calvi, M.D.; Cattedra di Gastroenterologia, Dipartimento di Medicina Interna, Univ. Torino, Sategna-Guidetti, S. Grosso; Unità di Gastroenterologia, IRCCS Policlinico S. Matteo, Univ. Pavia, Campanella J., M.D., Corazza G.R., M.D.; Unita’ Operativa di Nutrizione Clinica, Ospedale S. Eugenio, Roma, G. Sandri, M.D., G. Giorgetti, M.D.; Monica Amici, Dipartimento di Medicina Interna, Policlinico S. Orsola-Malpighi, Bologna, U. Volta, M.D., C. Parisi, M.D.; Servizio di Gastroenterologia ed Endoscopia Digestiva, Ospedale USL 9, Treviso, S. Lo Perfido, M.D., ; Divisione di Gastroenterologia, IRCCS Casa Sollievo Sofferenza, San Giovanni Rotondo, Foggia, F. Perri, M.D., V. Festa M.D.,; Clinica di Gastroenterologia ed Epatologia, Univ. Perugia, M.A. Pelli, M.D., M.L. Cavalletti M.D.,; Unità Operativa di Gastroenterologia ed Endoscopia Digestiva, Ospedale di Circolo e Fondazione Macchi, Varese, S. Segato, M.D., M. Curzio M.D.,; Servizio di Gastroenterologia ed Endoscopia Digestiva, Dipartimento Oncologia, Ospedale S. Giovanni AS, Torino, M. Pennazio M.D.,, F.P. Rossini, M.D.; Cattedra di Gastroenterologia, Ist. di Clinica Medica II, Univ. La Sapienza, Roma, A. Picarelli M.D.; Divisione di Gastroenterologia, Ospedale Mauriziano Umberto I, Torino, A. Pera, M.D., E. Ercole M.D.; Unità Operativa di Gastroenterologia, Dip.to di Patofisiologia Clinica, Univ. Pol. “Careggi” Firenze, M.T. Passaleva; Clinica Pediatrica, Servizio di Gastroenterologia, Univ. La Sapienza, Roma, M. Barbato M.D.,; Istituto di Medicina Interna, Univ. Cagliari, P. Usai M.D.,, M.F. Dore M.D.,; Divisione di Gastroenterologia, Ospedale Regionale, Bolzano, F.Chilovi, M.D., L. Piazzi, M.D. L.Zancanella M.D., and Servizio di Gastroenterologia Pediatrica e Servizio di Gastroenterologia, Univ. Modena, V. Boarino, M.D., A. Ferrari M.D.

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Silano, M., Volta, U., Vincenzi, A.D. et al. Effect of a Gluten-free Diet on the Risk of Enteropathy-associated T-cell Lymphoma in Celiac Disease. Dig Dis Sci 53, 972–976 (2008). https://doi.org/10.1007/s10620-007-9952-8

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  • DOI: https://doi.org/10.1007/s10620-007-9952-8

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