{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T20:55:54Z","timestamp":1775854554461,"version":"3.50.1"},"reference-count":28,"publisher":"BMJ","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"published-print":{"date-parts":[[2002,9]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Refractory sprue is defined as primary or secondary failure to respond to a gluten free diet in patients with coeliac disease-like enteropathy and may signify cryptic or overt enteropathy associated T cell lymphoma.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Aims:<\/jats:bold>\n                    To study in detail jejunal morphology and immunophenotypes in patients with refractory sprue in the search for features that might be useful to predict prognosis.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Patients:<\/jats:bold>\n                    Seven patients are described, representing all such cases identified in our hospital over a 13 year period.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods:<\/jats:bold>\n                    Biopsy and\/or surgical resection specimens were examined by morphology, immunohistochemistry, including enzymatic and immunofluorescent detection, and molecular biology.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    All patients had phenotypically abnormal intraepithelial lymphocytes (IELs) that lacked CD8, T cell receptor \u03b1\u03b2 (or \u03b3\u03b4), and\/or expressed CD30 in addition to variable expression of the natural killer cell receptor CD94. A monoclonal T cell population was present in six cases, data from the seventh being inconclusive. Three patients had overt lymphoma with CD30+ tumour tissue intervening between intact mucosa that contained neoplastic IELs. Intriguingly, CD30+ IELs were observed both a long way away from, and in direct continuity with, the tumours in these patients. Such CD30+ cells were hardly detected in patients without tumours, two of which are in good health several years after the initial diagnosis.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    Our data suggest that abnormal IELs in patients with refractory sprue are phenotypically heterogeneous. CD30 expression by these cells may indicate a worse prognosis, including the occurrence of overt lymphoma.\n                  <\/jats:p>","DOI":"10.1136\/gut.51.3.372","type":"journal-article","created":{"date-parts":[[2002,10,1]],"date-time":"2002-10-01T15:54:10Z","timestamp":1033487650000},"page":"372-378","source":"Crossref","is-referenced-by-count":55,"title":["Heterogeneity of intraepithelial lymphocytes in refractory sprue: potential implications of CD30 expression"],"prefix":"10.1136","volume":"51","author":[{"given":"I 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