Autoimmune enteropathy: not all flat mucosa mean coeliac disease.
A 62-year-old woman complaining of severe malabsorption was diagnosed with celiac disease based on the findings of flat, small intestinal mucosa and HLA-DQ2 positivity, although celiac serology was negative. This diagnosis was questioned due to the lack of clinical and histological improvement after a long period of strict gluten-free diet. The detection of enterocyte autoantibodies guided to the correct diagnosis of autoimmune enteropathy, leading to a complete recovery of the patient following an appropriate immunosuppressive treatment. Autoimmune enteropathy should be considered in the differential diagnosis of malabsorption with severe villous atrophy, including those cases with negative celiac-related serology.
Department of Medical and Surgical Sciences, University of Bologna, Italy.
Umberto
U
Volta
Gastroenterology Unit, Department of Gastroenterology, University of Pisa, Italy.
Maria Gloria
MG
Mumolo
Department of Medical and Surgical Sciences, University of Bologna, Italy.
Giacomo
G
Caio
Department of Medical and Surgical Sciences, University of Bologna, Italy.
Elisa
E
Boschetti
Department of Medical and Surgical Sciences, University of Bologna, Italy.
Rocco
R
Latorre
Department of Medical and Surgical Sciences, University of Bologna, Italy.
Fiorella
F
Giancola
Department of Medical and Surgical Sciences, University of Bologna, Italy.
Paola
P
Paterini
Department of Medical and Surgical Sciences, University of Bologna, Italy.
Roberto
R
De Giorgio
Autoimmune enteropathy; Enterocyte autoantibodies; Malabsorption; Villous atrophy