A 34-year-old man comes to the physician because of foul-smelling diarrhea, fatigue, and bloating for 6 months. During this time, he has had a 5-kg (11-lb) weight loss without a change in diet. He has type 1 diabetes mellitus that is well-controlled with insulin. Examination shows conjunctival pallor and inflammation of the corners of the mouth. The abdomen is soft, and there is diffuse tenderness to palpation with no guarding or rebound. Rectal examination reveals brown stool that is negative for fecal occult blood. Laboratory results are as follows: C-reactive protein level is normal. Which of the following pathologic gastrointestinal tract findings is most likely to be present in this patient?

Question

A 34-year-old man comes to the physician because of foul-smelling diarrhea, fatigue, and bloating for 6 months. During this time, he has had a 5-kg (11-lb) weight loss without a change in diet. He has type 1 diabetes mellitus that is well-controlled with insulin. Examination shows conjunctival pallor and inflammation of the corners of the mouth. The abdomen is soft, and there is diffuse tenderness to palpation with no guarding or rebound. Rectal examination reveals brown stool that is negative for fecal occult blood.  Laboratory results are as follows:  C-reactive protein level is normal.  Which of the following pathologic gastrointestinal tract findings is most likely to be present in this patient?

Quizplus · Accepted Answer

Eductional Objective: Celiac disease is an immune-mediated disorder triggered by dietary gluten that causes small-bowel malabsorption.  Because the proximal small bowel is primarily affected, iron deficiency leading to microcytic anemia is common.  Histopathology is characterized by intraepithelial lymphocytosis, loss of intestinal villi, and mucosal atrophy.

A 34-Year-Old Man Comes to the Physician Because of Foul-Smelling