Management of Non- responsive coeliac disease from a gastroenterologist perspective

Dr Kamran Rostami, Coeliac NZ Conference 2023
Dr Kamran Rostami is well known for his research on coeliac disease and non-coeliac gluten sensitivity. He received his MD degree from Carol Davila University Bucharest. He completed his PhD at the University of Amsterdam by which he defined the seronegative subgroup of coeliac disease and published the initial report on the correlation between serological tests and histological abnormalities in coeliac disease. This later became the inspiration and platform for avoiding biopsy approach in paediatric guidelines and recently young adults. He undertook his specialist training at Internal Medicine at the University of Groningen, the Netherlands. He continued and accomplished specialist training through the West Midlands Deanery in the UK and has been an attending Physician in the Gastroenterology Division, Department of Internal Medicine in both the UK and later at Palmerston North, New Zealand. His ongoing research interests are on gluten-related disorders and Nutrition therapy in Inflammatory bowel disease as highlighted in his publications.
Management of Non- responsive coeliac disease"
Non-responsive coeliac disease is defined as persistent symptoms, signs, and laboratory abnormalities including serology, micronutrient deficiencies or persistent/deterioration of histological changes typical of coeliac disease, despite at least 6 to 12 months of presumed adherence to a GFD. In this session, we discuss a range of differential diagnosis and potential therapeutic interventions appropriate to the etiology of non-responsiveness

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I have been diagnosed with seronegative celiac disease in 2018 with Marsh 3b atrophy. (Hla dq2 positive)
In 2022 I still had a Marsh 3a atrophy and in 2023 I went down with a chronic duedonitis diagnosis with subclinical hypothyroidism and gerd.
I still have a 50% of aberrant t cell with no cd4+ present.
Is this a classical finding in seronegative patient ?