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ANSWER: D
Critique
Villous blunting is not specific to celiac disease. In this case, the patient’s history supports a diagnosis of common variable immunodeficiency (CVID), which is characterized by low levels of two Ig classes and recurrent infections. The infections most commonly involve the upper and lower respiratory tract.
Chronic diarrhea is seen in 40%-60% of patients and may lead to malabsorption. Diarrhea can be the result of infections (most commonly Salmonella, Campylobacter, Clostridium difficile, and Giardia lamblia), inflammatory disorders, or malignancy. Biopsies reveal villous blunting similar to that seen in celiac disease. Unlike celiac disease, however, the biopsies lack plasma cells. These patients also differ from those with celiac disease in that their celiac serologies are negative.
- Shah V.H., Rotterdam H., Kotler D.P., et al. All that scallops is not celiac disease. Gastrointest. Endoscopy 2000;51:717-20.
- Sperber K.F., Mayer L. Gastrointestinal manifestations of common variable immunodeficiency. Immunol. Allergy Clin. North Am. 1988;8:423-34.
ANSWER: D
Critique
Villous blunting is not specific to celiac disease. In this case, the patient’s history supports a diagnosis of common variable immunodeficiency (CVID), which is characterized by low levels of two Ig classes and recurrent infections. The infections most commonly involve the upper and lower respiratory tract.
Chronic diarrhea is seen in 40%-60% of patients and may lead to malabsorption. Diarrhea can be the result of infections (most commonly Salmonella, Campylobacter, Clostridium difficile, and Giardia lamblia), inflammatory disorders, or malignancy. Biopsies reveal villous blunting similar to that seen in celiac disease. Unlike celiac disease, however, the biopsies lack plasma cells. These patients also differ from those with celiac disease in that their celiac serologies are negative.
ANSWER: D
Critique
Villous blunting is not specific to celiac disease. In this case, the patient’s history supports a diagnosis of common variable immunodeficiency (CVID), which is characterized by low levels of two Ig classes and recurrent infections. The infections most commonly involve the upper and lower respiratory tract.
Chronic diarrhea is seen in 40%-60% of patients and may lead to malabsorption. Diarrhea can be the result of infections (most commonly Salmonella, Campylobacter, Clostridium difficile, and Giardia lamblia), inflammatory disorders, or malignancy. Biopsies reveal villous blunting similar to that seen in celiac disease. Unlike celiac disease, however, the biopsies lack plasma cells. These patients also differ from those with celiac disease in that their celiac serologies are negative.
- Shah V.H., Rotterdam H., Kotler D.P., et al. All that scallops is not celiac disease. Gastrointest. Endoscopy 2000;51:717-20.
- Sperber K.F., Mayer L. Gastrointestinal manifestations of common variable immunodeficiency. Immunol. Allergy Clin. North Am. 1988;8:423-34.
- Shah V.H., Rotterdam H., Kotler D.P., et al. All that scallops is not celiac disease. Gastrointest. Endoscopy 2000;51:717-20.
- Sperber K.F., Mayer L. Gastrointestinal manifestations of common variable immunodeficiency. Immunol. Allergy Clin. North Am. 1988;8:423-34.