(HealthDay News) — Patients with celiac disease (CD) who have intestinal biopsy showing persistent villous atrophy are at increased risk for lymphoproliferative malignancy (LPM), according to research published in the Aug. 6 issue of the Annals of Internal Medicine.

Benjamin Lebwohl, M.D., of the Columbia University College of Physicians and Surgeons in New York City, and colleagues conducted a population-based cohort study to assess the association between mucosal healing or damage on intestinal biopsy in CD and risk for LPM.

The researchers found that, of 7,625 patients with CD who had follow-up intestinal biopsy after initial diagnosis, 3,308 patients (43%) had persistent villous atrophy. Patients with persistent villous atrophy had a higher rate of LPM (standardized incidence ratio [SIR], 3.78) than those with mucosal healing (SIR, 1.50) or that expected in the general population (SIR, 2.81).

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Compared with those with mucosal healing, CD patients with persistent villous atrophy were at increased risk for LPM (hazard ratio [HR], 2.26).

“Follow-up biopsies may be useful in identifying patients with CD at increased risk for LPM,” the authors write.