We report the case of a 53-year-old man with a history of hepatostatin (20ena underwent heart transplantation), in November 2005 with prednisone daily treatment including cyclosporine 120 mg/12 h, mycophenolate mofetil (100 mg/6),
The patient had a favorable outcome (from the cardiovascular point of view, but weight regained kg after May 2006 diarrheal stools of high volume, low frequency and without blood, occasional nausea, anorexia, and mild abdominal pain/2006).
In August 2006, he emphasized anti-gliadin antibodies to 130 U (representation: elevation < 30U) and upper gastrointestinal endoscopy (EDA) with the appearance of celiac disease and biopsy compatible with enteropathy.
Gluten suspension was indicated in the diet, progressing without changes in digestive symptoms.
In January 2007 control, it was decided to hospitalize for study and management due to persistence and greater nutritional compromise, 1 kg.
Nutritional assessment concluded severe marasmic caloric malnutrition.
Anti-endocrine antibodies, anti-transglutaminase and anti-gliadin antibodies were tested. Depositions for parasitic and bacterial elements were tested both fresh and in ordinary and special culture media, as well as for HIV.
Liver tests were normal and blood count with mild normochromic normocytic anemia (32%).
Abdominal computed tomography showed no pathological findings.
A study was completed with upper gastrointestinal endoscopy which showed flattening of the vested duodenal folds with edematous mucosa that showed erosions in the transverse colon and ascending inflammatory lesions. Samples were taken for pathological study.
Despite medical management and gluten-free diet, she continued with diarrheal stools and weight loss up to 43 kg. As serological tests were negative for celiac disease and symptoms persist despite a gluten-free diet (50 mg).
The patient recovered after the 3rd day with decreased volume of diarrheal stools and better food tolerance. After one week of suspension of MFM and feeding under a common regime, he had normal stools 15 kg.
In control 2 months after discharge, asymptomatic patient weighing 54 kg. A control ADD was performed in September 2007 with a normal impression. Samples of 2nd and 3rd portion of the duodenal mucosa were taken for pathological study.
In controls from January to April 2009, asymptomatic patient weighing 67 kg with a new UGE of normal appearance and biopsy of the second portion of the duodenum reporting nonspecific chronic duodenitis (Marsh Grade 0).
