Created by HELENE MOULIN on Jul 18, 2017 4:56:33 PM, Last modified by HELENE MOULIN on Nov 22, 2017 9:19:53 PM
A 66-year old man presented to the gastroenterologist with a four-month history of progressive watery diarrhea and 8-10 bowel movements/day. He was hospitalized twice during a 6-week period for dehydration and a 40-pound weight loss.
Stool studies demonstrated fecal fat; cultures and a C. difficile toxin assay were
negative.Other laboratory results included polyclonal hypergammaglobulinemia, normal IgA, mildly elevated celiac markers (IgA and IgG gliadin, tTG) with negative HLA DQ2/8 haplotype, and
normal serum chromogranin, gastrin, serotonin, and VIP levels. Mild ileal
thickening was noted on abdominal imaging, but no other abnormalities were
observed.Pertinent past medical history
included pancreatic insufficiency requiring enzyme supplementation and mild
hypothyroidism. These biopsies are from the duodenum.