Why don't we have extra risk of lymphoma?

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Zizzle
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Why don't we have extra risk of lymphoma?

Post by Zizzle »

New research out today confirming excess risk of lymphoma in untreated celiac disease. If we are pre-celiac, and we continue to have lymphocyte infiltration of our GI tract, shouldn't we be at similar risk for lymphoma? Also, I've always thought of lymphoma as a viral-induced cancer, namely Epstein Barr Virus. Could the untreated celiac simply mean our defenses against EBV activity are weakened? OR...maybe EBV activity triggered the celiac in the first place? Hmmm...

Patients with celiac disease have an elevated risk for lymphoproliferative malignancies, particularly if they have persistent villous atrophy, a population-based cohort study found.

Compared with the general population, the standardized incidence ratio for lymphoproliferative malignancy among patients with celiac disease was 2.81 (95% CI 2.10-3.67), according to Benjamin Lebwohl, MD, of Columbia University in New York, and colleagues.

And for those who continued to have villous atrophy of the intestinal mucosa, the standardized incidence ratio was 3.78 (95% CI 2.71-5.12), the researchers reported in the August 6 issue of Annals of Internal Medicine.

Previous studies have suggested that patients with celiac disease are at increased risk for lymphomas, and although the precise reason for this isn't clear, it may relate to ongoing villous atrophy in some patients, particularly those who fail to adhere to a gluten-free diet.
http://www.medpagetoday.com/Gastroenter ... logy/40836
1987 Mononucleosis (EBV)
2004 Hypomyopathic Dermatomyositis
2009 Lymphocytic Colitis
2010 GF/DF/SF Diet
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tex
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Post by tex »

Zizzle wrote:Why don't we have extra risk of lymphoma?
Who said we don't? We prevent the increased risk by properly treating the disease (with diet changes).

If higher levels of villus damage are associated with increased risk of lymphoma, that suggests that malabsorption is also associated with an increased risk of lymphoma. My guess would be that the additional risk is due to the more severe levels of vitamin D deficiency that are associated with more extensive villus damage. That is to say, malabsorption decreases vitamin D levels, and vitamin D deficiency is known to be associated with an increased risk of cancer.

Tex
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It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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