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A challenging case of chronic diarrhea
A challenging case of chronic diarrhea
Isabel Garrido, Armando Peixoto, Hélder Cardoso, Guilherme Macedo
Serviço de Gastrenterologia, Centro Hospitalar Universitário de São João
A 74-year-old Caucasian woman, without relevant past medical history, was admitted due to weight loss, abdominal pain and diarrhea for a year. Blood tests showed severe hydroelectrolytic and nutritional disorders. Upper endoscopy and colonoscopy had no relevant changes. Capsule endoscopy revealed extensively scattered lymphangiectasias, areas with shortened villi and some erosions in the jejunum and ileum. The histological examination showed severe mucosal atrophy, crypt hyperplasia and lymphoplasmacytic infiltration in the lamina propria, without significant intraepithelial lymphocytosis. Towards the diagnosis of autoimmune enteropathy, treatment with corticosteroids was started, with a quick improvement of symptoms and nutritional deficits.
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