Factitious diarrhea masquerading as refractory celiac disease.
A 23-year-old female with a history of a histologically confirmed diagnosis of celiac disease was referred to our institution for refractory celiac disease for consideration of immunosuppressive therapy. Full workup revealed an elevated fecal magnesium level, and a concurrent diagnosis of laxative abuse was confirmed after discussion with the family. This case highlights the importance of considering factitious diarrhea in all patients admitted for refractory diarrhea, even those with documented underlying conditions.
Keswani
Rajesh N
RN
Section of Gastroenterology, University of Chicago Hospitals, and Department of Internal Medicine, University of Chicago Hospitals, Chicago, IL 60637, USA. rkeswani@medicine.bsd.uchicago.edu
Sauk
Jenny
J
Kane
Sunanda V
SV
D000328:Adult; D001706:Biopsy; D002446:Celiac Disease / Q000150:complications / Q000175:diagnosis*; D003937:Diagnosis, Differential; D003967:Diarrhea / Q000175:diagnosis / Q000209:etiology*; D004386:Duodenum / Q000473:pathology; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans