Table of ContentsDefinition / general | Diagrams / tables | Clinical features | Microscopic (histologic) images
Cite this page: Gulwani, H. Refractory sprue. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/smallbowelrefractory.html. Accessed March 23rd, 2018.
Definition / general
- Also called unclassified sprue
- Celiac sprue that does not respond to gluten free diet of 6 - 12 months (note: wheat is present in many foods so must verify that diet is actually gluten free) and is not due to other disorders
- Must rule out gluten contamination, microscopic colitis, bacterial overgrowth, pancreatic insufficiency, lactose intolerance, inflammatory bowel disease, lymphoma (Gut 2010;59:547)
- Two subtypes: type 1 (normal intraepithelial lymphocyte phenotype) and type 2 (presence of abnormal clonal intraepithelial lymphocyte phenotype)
- Often associated with thromboembolic events, coexisting autoimmune disorders, cavitation of mesenteric lymph nodes and hyposplenism, lymphoma