Azathioprine and prednisone combination therapy in refractory coeliac disease

@article{Goerres2003AzathioprineAP,
  title={Azathioprine and prednisone combination therapy in refractory coeliac disease},
  author={Marije S. Goerres and Jos W. R. Meijer and P. J. Wahab and J A Kerckhaert and Patricia J.T.A. Groenen and J Han van Krieken and Chris J. Mulder},
  journal={Alimentary Pharmacology \& Therapeutics},
  year={2003},
  volume={18}
}
Introduction:  Refractory coeliac disease (RCD) is a rare syndrome with a poor prognosis, defined by malabsorption due to gluten‐related enteropathy after initial or subsequent failure of a strict gluten‐free diet and after exclusion of any disorder mimicking coeliac disease. 
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Tioguanine (TG) might be better tolerated and more efficacious owing to a simpler metabolism towards bioactivation than corticosteroids in refractory coeliac disease type I.
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The case of a 54 year-old man with refractory celiac disease is presented who required treatment with both budesonide and azathioprine and a concise review of the clinical Management of Refractory Celiac Disease is performed.
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Different types of refractory celiac disease are described and diagnostic and therapeutic guidelines for its clinical management are proposed.
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The clinical characteristics of RCDI and RCDII, diagnostic approach, and the latest insights in treatment options are described.
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The distinctive diagnostic features of RCDI and RCDII, the risk of developing overt lymphoma and different therapeutic approaches are reviewed.
Editorial: Is Refractory Celiac Disease More Severe in Old Europe?
TLDR
The diagnostic criteria of RCDI and RCDII, and the possible factors underlying the more severe expression of celiac disease in Europe, are discussed.
Management of Patients with Refractory Coeliac Disease
TLDR
Subjects with RCD carry a high risk of complications, including ulcerative jejunitis and lymphoma affecting the small intestine, the latter termed enteropathy-associated T-cell lymphoma (EATL).
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TLDR
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TLDR
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TLDR
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TLDR
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