Case ReportsSuccessful infliximab treatment for steroid-refractory celiac disease: A case report☆,☆☆
Section snippets
Case report
A 47-year-old woman from the north of Scotland presented in December 1993 to her local hospital with a 5-year history of profuse intractable diarrhea and weight loss. Initial investigations included a normal barium follow through, colonoscopy and biopsies, glucose hydrogen breath test, and computerized tomography scan of abdomen. In addition, antibody to double-stranded DNA was negative (<10 U). In February 1995, a jejunal biopsy showed subtotal villous atrophy and an increased intraepithelial
Discussion
We describe a case of a white female with a diagnosis of celiac disease confirmed by elevated titers of antigliadin and antiendomysium IgG antibodies together with subtotal villous atrophy in jejunal and distal duodenal histology. She was IgA deficient. Her disease was uncontrolled despite good compliance with a gluten-free diet. Further treatment with immunosuppressives and oral steroids did not result in a sufficient clinical response, and she continued to complain of diarrhea and weight loss
Acknowledgements
The authors thank John Bode, Edinburgh, Scotland, for help in histopathology and J. A. Garrote and E. Arranz, Universidad de Valladolid, Spain, and the Scottish Blood Transfusion Service, Edinburgh, Scotland, for help in DQ-2 typing.
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Address requests for reprints to: Subrata Ghosh, M.D., F.R.C.P., Gastrointestinal Laboratory, Western General Hospital, Crewe Road, Edinburgh, EH4 2XU, Scotland. e-mail: [email protected]; fax: (44) 131-537-1007.
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Drs. Gillett and Arnott made equal contributions to this article.