Refractory celiac disease

Expert Rev Gastroenterol Hepatol. 2014 Mar;8(3):323-8. doi: 10.1586/17474124.2014.887438. Epub 2014 Feb 6.


A small subset of celiac disease (CD) patients becomes refractory to a gluten-free diet with persistent malabsorption and intestinal villous atrophy. Diagnosis of this condition defined as refractory celiac disease (RCD) is made after exclusion of other small bowel diseases with villous atrophy. RCD has been subdivided into two subgroups according to the normal or abnormal phenotype of intraepithelial lymphocytes. Whereas normal RCD is hardly distinguishable from active CD, abnormal RCD has a severe clinical presentation and a very poor prognosis. We precisely describe below the different types of RCD and propose diagnostic and therapeutic guidelines for its clinical management.

Publication types

  • Review

MeSH terms

  • Celiac Disease / diagnosis*
  • Celiac Disease / diet therapy*
  • Celiac Disease / mortality
  • Diet, Gluten-Free*
  • Disease Management
  • Humans
  • Phenotype
  • Practice Guidelines as Topic
  • Survival Rate
  • Treatment Failure