A person has history of steatorrhoea of long duration. D-sylose was ordered. 5 hour urine sample show <4.5 g excretion after giving 25g D-xylose. What is/are the probable diagnosis
Correct Answer: Celiac disease
Description: Coeliac disease or celiac disease is a long-term autoimmune disorder that primarily affects the small intestine.Classic symptoms include gastrointestinal problems such as chronic diarrhoea, abdominal distention, malabsorption, loss of appetite and among children failure to grow normally. This often begins between six months and two years of age. Non-classic symptoms are more common, especially in people older than two years. There may be mild or absent gastrointestinal symptoms, a wide number of symptoms involving any pa of the body or no obvious symptoms.Coeliac disease was first described in childhood;however, it may develop at any age.It is associated with other autoimmune diseases, such as diabetes mellitus type 1 and thyroiditis, among others. The classic symptoms of untreated coeliac disease include pale, loose, and greasy stool (steatorrhoea), and weight loss or failure to gain weight. Other common symptoms may be subtle or primarily occur in organs other than the bowel itself.It is also possible to have coeliac disease without any of the classic symptoms at all.This has been shown to comprise at least 43% of presentations in children. Fuher, many adults with subtle disease may only present with fatigue or anaemia. Many undiagnosed individuals who consider themselves asymptomatic are in fact not, but rather have become accustomed to living in a state of chronically compromised health. Indeed, after staing a gluten-free diet and subsequent improvement becomes evident, such individuals are often able to retrospectively recall and recognise prior symptoms of their untreated disease which they had mistakenly ignored. Ref Davidson edition23rd pg 830
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