REFRACTORY COELIAC DISEASE

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REFRACTORY COELIAC DISEASE Jan Kencian Australia C
ASE HISTORY 47 year old male baker. April 2007.
Presented with 12 month history of weight loss,
diarrhoea and severe epigastric pain, worse after
eating. He was found to be anaemic with reduced
iron stores and RBC folate. ESR was elevated. TTG
Abs 29 (lt7). Endoscopy and histology
consistent with coeliac disease. He was commenced
on a gluten free diet and had an initial mild
improvement in symptoms. November 2008 No
clinical or endoscopic improvement. TTG Abs 9.
Rebiopsied.
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