A 45-year-old woman with no significant morbid history.
She suffered from vomiting and diarrhea without blood or mucus for a week.
Physical examination revealed increased air-fluid sounds.
Infectious diarrhea was diagnosed and oral ciprofloxacin was prescribed.
Four days later the patient continued with diarrhea, complained of abdominal pain, and abdominal examination revealed increased air-fluid sounds and drooling, so she was hospitalized.
Episodes with progressive abdominal disfunction.
A simple abdominal X-ray showed air-fluid levels in the small intestine and a computed tomography showed double intestinal intussusception.
She was operated on and found only a retroumbilical adhesion, which was resected.
There were no intestinal resections or biopsies.
Surgery ceased diarrhea and abdominal pain, leaving the hospital in good condition.
1.
Days later the abdominal pain and diarrhea recurred, which was accompanied by hematochezia and was hospitalized again.
Laboratory tests revealed hypoalbuminemia of 26 g/L elevated alkaline phosphatases 269 U/L (VN: 50-136), hypoprothrombinemia and partial thromboplastin time.
Enteroclysis performed during computed tomography showed three intussusceptions, two proximal and one distal, which were resolved with the administration of the enteral contrast medium.
He suffered a celiac disease.
Antiendomysium antibodies (indirect immunofluorescence) were positive and IgA antitransglutaminase antibodies determined by enzyme immunoassay were also positive at a value of 21.5kitml reference (Eurosi/1).
A panendoscopy showed a stalked mucosa in the second portion of the duodenum.
Biopsy showed distortion of architecture with complete flattening of intestinal villi. The lamina propria was expanded by an infiltrate with enteroplasmocitic epithelium 100 stage III lymphocytic lining (60 lymphocytes per lymphocytic).
A gluten-free diet was prescribed and, to date, one year later, the patient remains asymptomatic.
The family does not know members affected by this condition.
