Detection of Active Epstein–Barr Virus Infection in Duodenal Mucosa of Patients With Refractory Celiac Disease

Vittorio Perfetti, Fausto Baldanti, Marco Vincenzo Lenti, Alessandro Vanoli, Federico Biagi, Marta Gatti, Roberta Riboni, Elena Dallera, Marco Paulli, Paolo Pedrazzoli, Gino Roberto Corazza

Research output: Contribution to journalArticlepeer-review


Refractory celiac disease is characterized by mucosal damage in patients with celiac disease despite a gluten-free diet. Little is known about the mechanisms that cause persistent intestinal inflammation in these patients. We performed a case-control study of 17 consecutive patients diagnosed with refractory celiac disease from 2001 through 2014 (median age, 51 y; 10 women) and 24 patients with uncomplicated celiac disease (controls) to determine whether refractory disease is associated with infection by lymphotropic oncogenic viruses. We performed real-time PCR analyses of duodenal biopsy samples from all patients to detect Epstein–Barr virus (EBV), human herpesvirus-8, and human T-cell lymphotropic virus-I, -II, or -III. We used in situ hybridization and immunohistochemical analyses to identify infected cells and viral proteins. We did not detect human herpesvirus-8 or human T-cell lymphotropic viruses in any of the biopsy specimens. However, 12 of 17 (70.5%) biopsy specimens from patients with refractory celiac disease were positive for EBV, compared with 4 of 24 (16.6%) biopsy specimens from controls (P < .001). EBV was detected in inflammatory cells and enterocytes. An analysis of latency- and replication-associated proteins confirmed active infection. Further studies are needed to determine whether EBV infection contributes to the pathogenesis of refractory celiac disease and enteropathy-associated T-cell lymphoma.

Original languageEnglish
Pages (from-to)1216-1220
Number of pages5
JournalClinical Gastroenterology and Hepatology
Issue number8
Publication statusPublished - Aug 1 2016


  • Celiac Disease Complications
  • EATL
  • EBV
  • Risk Factor

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology


Dive into the research topics of 'Detection of Active Epstein–Barr Virus Infection in Duodenal Mucosa of Patients With Refractory Celiac Disease'. Together they form a unique fingerprint.

Cite this