A small subset of coeliac disease (CD) patients experience persisting or recurring symptoms despite strict adherence to a gluten-free diet (GFD). When other causes of villous atrophy have been excluded, these patients are referred to as refractory celiac disease (RCD) patients. RCD can be divided in two types based on the absence (type 1) or presence (type II) of an, usually clonal, intraepithelial lymphocyte population with aberrant phenotype.

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