Coeliac disease
Coeliac disease patients may be asymptomatic, minimally symptomatic, and/or well-controlled on a gluten-free diet (i.e. a diet free of cereal, rye, wheat, and barley) but nonetheless develop EATL. About 46% of all AETL cases occur in this setting and have had their malignancy described as "de novo" EATL. The remaining ~54% of EATL cases develop in coeliac disease patients whose disease becomes refractory to dietary control, exhibits increasing symptoms, and progress over ~4–10 years through Type I refractor coeliac disease (Type 1 RCD) and Type II refractory coeliac disease (Type II RCD) to become EATL. The rates at which non-refractory celiac disease, Type I RCD, and Type II RCD progress to "de novo" or EATL are &lt;1%, 3-14%, and 33-52%, respectively.