Article Text

Steroids in villous atrophy: opening a can of worms?
  1. Lennard Lee1,
  2. Paul Blaker1,
  3. Baljit Gill2,
  4. Sebastian Lucas2,
  5. Victoria Muir3,
  6. Peter M Irving1
  1. 1Department of Gastroenterology, St Thomas' Hospital, London, UK
  2. 2Department of Histopathology, St Thomas' Hospital, London, UK
  3. 3Belgrave Medical Centre, London, UK
  1. Correspondence to Lennard Lee, St Thomas' Hospital, Westminster Bridge Street, London SE1 7EH, UK; lennard.lee{at}


A 60 year old man presented to the emergency department with septic shock and respiratory distress. He noted significant weight loss over the last 6 months with associated postprandial bloating. Endoscopy demonstrated partial villous atrophy. He had been on a gluten free diet, received empirical treatment for giardiasis and was receiving treatment with high dose systemic steroids for retroperitoneal fibrosis. This case discusses histology findings, differentials and reason for this acute presentation.

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  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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