A 14-month-old kid is brought to the office because she has had diarrhea for the past two months. Her parents note that she gets 3-5 loose, nonbloody bowel motions per day, with some vomiting. She was solely breastfed until she was 9 months old and has since enjoyed a diversified diet that includes whole milk, fruits, vegetables, bread, and meats. However, the girl has been less interested in food in recent weeks. There is no history of travel or interaction with people who have comparable symptoms. The patient seems well on physical examination, but has dropped 1.1 kg (2.5 lb) in the previous two months. The display depicts the results of a duodenal biopsy after laboratory assessment. Which of the following would most likely improve this patient's symptoms?

Question

A 14-month-old kid is brought to the office because she has had diarrhea for the past two months. Her parents note that she gets 3-5 loose, nonbloody bowel motions per day, with some vomiting. She was solely breastfed until she was 9 months old and has since enjoyed a diversified diet that includes whole milk, fruits, vegetables, bread, and meats. However, the girl has been less interested in food in recent weeks. There is no history of travel or interaction with people who have comparable symptoms. The patient seems well on physical examination, but has dropped 1.1 kg (2.5 lb) in the previous two months. The display depicts the results of a duodenal biopsy after laboratory assessment.  Which of the following would most likely improve this patient's symptoms?

Quizplus · Accepted Answer

Eductional Objective: Celiac disease (gluten-sensitive enteropathy) often manifests itself between the ages of 6 and 24 months as stomach discomfort, diarrhea, vomiting, and weight loss. A biopsy of the duodenum revealed crypt hyperplasia, villous atrophy, and lymphocyte infiltration. Gluten-free diet treatment relieves symptoms and normalizes serology and histology.

A 14-Month-Old Kid Is Brought to the Office Because She