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Article: Celiac Disease Refractory to a Gluten-free Diet?/Commentary/Commentary
- Article from:
- Clinical Chemistry
- Article date:
- February 1, 2008
- Author:
CopyrightCopyright American Association for Clinical Chemistry Feb 2008. Provided by ProQuest LLC. (Hide copyright information)
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CASE DESCRIPTION
A 75-year-old woman from an outside hospital was referred because of continued signs and symptoms of celiac disease (gluten-sensitive enteropathy) that persisted despite self-reported adherence to a gluten-free diet. The patient reported excessive gas, bowel distension, a 15-pound weight loss over the past few years, insomnia, and a rash over her lower extremities. The patient had required hospitalizations, intravenous fluids, and continuing therapy with corticosteroids for 6 months.
A diagnosis of celiac disease had been made 6 years previously, based on (a) typical gastrointestinal signs and symptoms with negative stool cultures and Clostridium difficile toxin assay, (b) ...