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Article 20, 3/2016

CASE REPORT

Serendipity in Refractory Celiac Disease: Full Recovery of Duodenal Villi and Clinical Symptoms after Fecal Microbiota Transfer

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Yvette H. van Beurden1,2, Tom van Gils1, Nienke A. van Gils3, Zain Kassam4,5, Chris J.J. Mulder1, Nieves Aparicio-Pagés3

1) Dept. of Gastroenterology & Hepatology, and
2) Dept. of Medical Microbiology & Infection Control, VU University Medical Center, Amsterdam, The Netherlands
3) Dept. of Gastroenterology & Hepatology, Canisius Wilhelmina Ziekenhuis, Nijmegen, The Netherlands
4) Massachusetts Institute of Technology, Cambridge, Massachusetts, USA;
5) OpenBiome, Medford, Massachusetts, USA.

DOI: http://dx.doi.org/10.15403/jgld.2014.1121.253.cel

ABSTRACT
Treatment of refractory celiac disease type II (RCD II) and preventing the development of an enteropathy associated T-cell lymphoma in these patients is still difficult. In this case report, we describe a patient with RCD II who received fecal microbiota transfer as treatment for a recurrent Clostridium difficile infection, and remarkably showed a full recovery of duodenal villi and disappearance of celiac symptoms. This case suggests that altering the gut microbiota may hold promise in improving the clinical and histological consequences of celiac disease and/or RCD II.

Key words: refractory celiac disease type II – Clostridium difficile infection – fecal microbiota transplantation

Abbreviations: CDI: Clostridium difficile infection; EATL : enteropathy associated T-cell lymphoma; FMT: fecal microbiota transfer; IEL: intraepithelial lymphocytes; RCD II: refractory celiac disease type II; TPN: total parenteral nutrition.