We tend to think of gluten-sensitive enteropathy as a disease of the small bowel mucosa , and we focus our attention on the underlying immunological events, the histopathology and the functional consequences of the changes to the intestinal mucosa. However, as confirmed by this case, there is more extensive involvement of small bowel […]
Small bowel radiography was normal and at endoscopy ‘scalloping’ was seen in the proximal small bowel. The immunoglobulin G antiendomysial antibody titre was positive to 1:1280 (normal less than 1:2.5) and the lactulose/mannitol ratio was increased to 0.092 (normal less than 0.025). Severe villous atrophy, crypt hyperplasia and inflammatory infiltrate consistent with celiac disease was seen in the histopathology of the duodenum (Figure 2). Bone densitometry revealed osteopenia .
The clinical presentation of celiac includes several common and a number of unusual presentations. The present case falls into the latter category, and the authors discuss the features that highlight aspects of the pathophysiology of this disease that have received little attention in the literature.
A 27-year-old woman with a 10-year history of uncomplicated […]
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