To the Editor: A 56-year-old woman had a two-year history ofrefractory celiac disease for which she had taken prednisone(20 mg per day) for the previous six months, during which timeher condition had worsened despite a gluten-free diet. Duodenalbiopsy showed severe atrophy with crypt hyperplasia and increasedintraepithelial lymphocyte counts. On immunohistochemical analysis,the cytoplasm was positive for CD3 and negative for CD4 andCD8 (Figure 1). Flow-cytometric analysis of intraepitheliallymphocytes showed that more than 50 percent of the cells expressedT-cell receptor (TCR). In addition, we identified a secondaberrant population of . . . [Full Text of this Article]
Green, P. H.R., Cellier, C.
(2007). Celiac Disease. NEJM
357: 1731-1743
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Verbeek, W. H.M., Mulder, C. J.J., Zweegman, S., Vivas, S., Ruiz de Morales, J. M., Ramos, F.
(2006). Molecular mechanisms in melanoma.. NEJM
355: 1396-1396
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