Summary

This case study describes the disease course and treatment of a rare disorder, refractory coeliac disease. This disorder is associated with a marked increase in the risk of development of enteropathy-associated T-cell lymphoma. The patient in question developed coeliac symptoms despite strict adherence to a gluten-free diet, having been symptom-free for over 7 years. She presented with marked oedema of the legs and a distended abdomen. Investigations—laboratory, radiological and enteroscopy findings—were consistent with the development of refractory coeliac disease. This case illustrates the background and course of this disease, and the treatment options.