Dickey William
Department of Gastroenterology, Altnagelvin Hospital, Londonderry, Northern Ireland, UK.
Nat Clin Pract Gastroenterol Hepatol. 2007 Aug;4(8):463-7. doi: 10.1038/ncpgasthep0897.
A 65-year-old white female who presented with flatulence and weight loss was investigated by celiac antibody testing, esophagogastroduodenoscopy, duodenal biopsy and colonoscopy. There were no positive findings, except for diverticulosis. Almost 5 years later repeat investigations performed in response to the patient's anemia confirmed the development of celiac disease. After 18 months of symptom improvement as a result of gluten exclusion the patient developed diarrhea, and colonoscopy revealed ulcerative colitis.
Physical examination; analysis of full blood count; measurement of serum ferritin, vitamin B(12), folate and C-reactive protein levels; thyroid and autoantibody profiling (including analysis of endomysial and tissue transglutaminase antibodies); CT scanning of the chest, abdomen and pelvis; and performance of esophagogastroduodenoscopy, push enteroscopy, colonoscopy and wireless capsule endoscopy.
Celiac disease and ulcerative colitis.
Gluten-free diet, mesalazine and prednisolone.
一名65岁白人女性，出现肠胃胀气和体重减轻症状，接受了乳糜泻抗体检测、食管胃十二指肠镜检查、十二指肠活检及结肠镜检查。除憩室病外，未发现阳性结果。近5年后，因患者贫血进行的重复检查确诊为乳糜泻。在排除麸质后症状改善18个月，患者出现腹泻，结肠镜检查显示为溃疡性结肠炎。
体格检查；全血细胞计数分析；血清铁蛋白、维生素B12、叶酸及C反应蛋白水平测定；甲状腺及自身抗体分析（包括肌内膜和组织转谷氨酰胺酶抗体分析）；胸部、腹部及骨盆CT扫描；食管胃十二指肠镜检查、推进式小肠镜检查、结肠镜检查及无线胶囊内镜检查。
乳糜泻和溃疡性结肠炎。
无麸质饮食、美沙拉嗪及泼尼松龙。
