case_images: PMC9425893_01
case_images: (a) Duodenal biopsy consistent with Marsh 3a:showing partial villous atrophy, intra epithelial lymphocytes, lamina propria inflammatory infiltrate. (b) Liver biopsy showing giant cell formation, interface hepatitis, and inflammatory infiltrate.
case_images: 10.1177_11795565221120565-fig1.jpg
case_images: PMC9425893_01_10.1177_11795565221120565-fig1.jpg
case_images: fig1-11795565221120565
case_images: TTG IgA <0.1 (positive >10), Anti TTG Ig G 13 (positive >10) and was also positive for deaminated gliadin peptide (DGP) IgA. To confirm the diagnosis esophagogastroduodenoscopy (EGD) was done which was consistent with diagnosis of Celiac disease (MARSH Type 3a) showing distorted villous architecture, increased intraepithelial lymphocytes (Figure 1a). Liver biopsy showed moderate portal inflammation with foci of interface hepatitis, parenchymal cholestasis, and giant cell changes along with fibrous portal expansion with short fibrous septae, all favoring autoimmune hepatitis type I (Figure 1b).