A 24 year old nursing student was having difficulty keeping up in class because of extreme fatigue.She sought help from the Students' Health Service.A full blood count (FBC)showed anaemia with increased RBC (red blood cell)size (macrocytic anaemia).An upper GI endoscopy was performed,and biopsies taken.A representative section of the biopsy is shown in the accompanying photomicrograph,with normal small bowel shown on the left for comparison (villi are identified as "V").Which one of the following is the best diagnosis?

Question

Quizplus · Accepted Answer

The patient has coeliac disease,or gluten-sensitive enteropathy.The disease is caused by sensitivity to gluten,which is found in many foods.The biopsy is diagnostic,showing an inflammatory infiltrate and blunting of the villi,which causes malabsorption.The malabsorption can cause vitamin deficiencies,particularly of the B vitamins,which can lead to macrocytic anaemia and therefore,fatiguEThe disease can be controlled by placing the patient on a gluten-free diet.

A 24 Year Old Nursing Student Was Having Difficulty Keeping