A 68-year-old woman began to be studied by her gastroenterologist in December 2003.
She had been diagnosed with celiac disease for 30 years and the gluten-free diet had followed her very irregularly and consequently had frequent diarrheas.
He was hypertensive and non-diabetic.
For six months she had diarrheas and reached ten stools a day, diurnal and nocturnal, and feces were liquid or pasty.
Meteorism and lost 5 kg of weight.
Coinciding with the new diarrheic sprout, the gluten-free diet was correctly started.
In the general analytical study it was found that he had no anemia and the determination of 24-hour fecal fat was 30 g and positive antiendomysial antibodies.
The intestinal transit lasted 5 hours and there was flocculation and contrast fragmentation.
Intestinal biopsy was performed and reported as mild signs of nonspecific inflammation.
He was admitted to our service in the month of June 2004 and the clinical situation was similar.
In the analytical study, xylosemia and immunoglobulins were normal and antigliadin and antiendomysium antibodies had been negativized.
A new intestinal transit (after seven months of the previous one) was performed and it was normal.
A new duodenal biopsy was performed and at this time she was informed of partial celiac disease (CD3) with cryptic hyperplasia, stage IIIa of the ESPGAN classification, with immunohistochemical study with all intralymphocytosis CD8.
With this diagnosis she is discharged to continue her follow-up in our consultations and the suspicion that she might have another cause of illness, such as microscopic colitis, contributing to the current diarrheal syndrome.
Ambulant colonisation was performed with a total anaesthesia which was normal but unfortunately the biopsy was damaged during processing.
Clinically he was better and defecated three times a day and his stools were pasty.
In the analytical study hemoglobin was 113 g/L, with normal sideremia and lactose curve.
Fat removal in 24-hour faeces was 7.2 g (normal up to 6 g).
We convinced the patient to perform another biopsy with the only objective of obtaining biopsies, which were reported as lymphocytic colitis and in the immunohistochemical study, the lymphocytic colitis is characteristic of the patient.
The patient was prescribed treatment with a calcium-free diary table and a gluten-free diet. A four-month follow-up was performed. The patient was perfectly free of diarrhea and had regained 5 kg of weight.
