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Diagnostic Challenges of Celiac Disease



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Autoimmune Enteropathy2

Slide 9

June 2010

Not all that flattens is celiac disease. This is a case of a 65-year-old male with a history of diarrhea and weight loss. The tissue transglutaminase antibody and endomysial antibodies were performed and were negative. The patient had no response to a gluten-free diet. His intestinal biopsies showed quite substantial change with inflammation, partial villous atrophy, marked crypt hyperplasia and, this photo micrograph illustrates, the dense lymphoplasmacellular infiltrate. And, to the untrained eye, one would say this looks very much like celiac disease. However, the patient’s lack of response and negative serology at the time of initial diagnosis should alert the clinician that this may not be celiac disease and there may be an alternative explanation.

Autoimmune Enteropathy2

 


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