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Diagnostic Challenges of Celiac Disease



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Minimal Disease: Uncertain Histology

Slide 13

June 2010

The next case. A 65-year-old female patient with dyspepsia and a 6-month history of epigastric pain and bloating. Is not anemic. However, a duodenal biopsy performed shows increased intraepithelial lymphocytes without villous atrophy.

The next logical step could be:
1. Put her on a gluten-free diet, presuming that she has celiac disease;
2. Give her a drug called budesonide, a powerful, topically active steroid;
3. Order a Celiac Disease Comprehensive Cascade; or
4. Treat her for Crohn disease.

In this case, rather than assuming that this patient has celiac disease, or treating her with an anti-inflammatory or treating for another disease, that’s Crohn disease, the next logical test would be to undertake the Celiac Disease Comprehensive Cascade.

Minimal Disease: Uncertain Histology

 


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