This patient has a malabsorption syndrome accompanied by polyarthritis. The differential diagnoses includes inflammatory bowel disease, Whipples disease, and celiac sprue. Villous atrophy on biopsy along with the rash on the patients arms, known as dermatitis herpetiformis, indicate a diagnosis of celiac sprue. Treatment consists of a gluten-free diet. Inflammatory bowel disease is less likely because the diarrhea is not bloody. Whipples disease is incorrect because the patient does not have lymphadenopathy. Irritable bowel syndrome is not associated with joint pains. Dysentery would have a more acute presentation with bloody diarrhea.
- Celiac sprue.
Click here to return to the questions
Click here to read more about Extraintestinal Manifestations
of Hepatogastrointestinal Diseases
(Requires Adobe Acrobat Reader)
Check our archives to test your knowledge in other clinical signs:
If you do not already have Acrobat Reader, simply click on the icon below, scroll down to the "Get the Free Acrobat Reader" heading and follow the instructions to install the program. Acrobat enables you to convert any document into an Adobe Portable Document Format (PDF) file for easy viewing.
Download Adobe Acrobat Reader
Seminars in Medical Practice
Hospital Physician Board Review Manuals
Copyright © 2009, Turner White Communications
Updated 1/04/08 kkj