Celiac disease vs Infectious malabsorption patterns
How to tell Celiac disease and Infectious malabsorption patterns apart when a board question makes them look alike.
Celiac is gluten-autoimmune villous atrophy; tropical sprue is exposure-responsive malabsorption; Whipple is PAS-positive systemic infection.
Side by side
Gluten-sensitive immune enteropathy with diarrhea, weight loss, iron deficiency, dermatitis herpetiformis, anti-tTG/anti-endomysial antibodies, and villous atrophy.
Tropical sprue follows tropical exposure with folate/B12 malabsorption; Whipple disease causes systemic symptoms with PAS-positive macrophages.
Immune reaction to gluten peptides damages small-bowel mucosa in genetically susceptible patients.
Tropical sprue is infection-associated malabsorption; Whipple disease is Tropheryma whipplei infection with macrophage-laden tissue.
Villous atrophy, crypt hyperplasia, intraepithelial lymphocytes, and anti-tTG support celiac disease.
Tropical exposure with folate/B12 deficiency supports tropical sprue; PAS-positive macrophages support Whipple disease.
The trap
All can cause malabsorption, so antibodies, travel/exposure, and PAS-positive macrophages separate them.
The repair move
For malabsorption, sort immune gluten disease, tropical exposure, and PAS-positive systemic infection.
Try a free question
CoreA patient has chronic diarrhea, weight loss, iron deficiency, dermatitis herpetiformis, and small-bowel biopsy showing villous atrophy with crypt hyperplasia. Which diagnosis is most likely?
Show answer and explanation
Answer: A. Celiac disease. Celiac disease is immune-mediated gluten sensitivity with villous atrophy, crypt hyperplasia, and anti-tTG/anti-endomysial antibodies.
Why the other choices are tempting
- B. Tropical sprue follows endemic exposure and often causes folate and B12 deficiency.
- C. Whipple disease causes PAS-positive macrophages with systemic findings.
- D. Lactose intolerance causes osmotic symptoms without villous atrophy.
- E. Ulcerative colitis is colonic inflammatory disease.
Flashcards
Tap a card to flip it.
What HLA association supports celiac susceptibility?
HLA-DQ2 and HLA-DQ8 are the classic genetic susceptibility associations.
What biopsy clue supports celiac disease?
Villous atrophy with crypt hyperplasia supports immune-mediated enteropathy.
Quick answers
What is the fastest way to tell Celiac disease from Infectious malabsorption patterns?
Celiac is gluten-autoimmune villous atrophy; tropical sprue is exposure-responsive malabsorption; Whipple is PAS-positive systemic infection.
What is the key clue for Celiac disease?
Gluten-sensitive immune enteropathy with diarrhea, weight loss, iron deficiency, dermatitis herpetiformis, anti-tTG/anti-endomysial antibodies, and villous atrophy.
What is the key clue for Infectious malabsorption patterns?
Tropical sprue follows tropical exposure with folate/B12 malabsorption; Whipple disease causes systemic symptoms with PAS-positive macrophages.
What is the common trap with Celiac disease vs Infectious malabsorption patterns?
All can cause malabsorption, so antibodies, travel/exposure, and PAS-positive macrophages separate them.