Large Droplet
Steatosis in Coeliac Disease
Husová L.1, ŠenkyříkM.1, Lata J.1, StratilD.2, Hrobař P.3, HusaP.4, Utěšený J.5
1Interní gastroenterologická klinika Lékařské fakulty MU a FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Petr Dítě, DrSc. 2II. Patologicko-anatomický ústav Lékařské fakulty MU a FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Karel Dvořák, DrSc. 3Radiologická klinika Lékařské fakulty MU a FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Vlastimil Válek, CSc. 4Klinika nemocí infekčních Lékařské fakulty MU a FN Brno, pracoviště Bohunice, přednosta doc. MUDr. Pavel Chalupa, CSc. 5II. dětská klinika Lékařské fakulty MU a FN Brno, pracoviště Fakultní dětská nemocnice J. G. Mendela, přednosta doc. MUDr. Zdeněk Doležal, CSc. |
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Summary:
Authors monitored a case of a 25 years old woman who was admitted for swelling of lower limbs.
Laboratory results showed hypoproteinemia, elevation of liver enzymes, and prolonged prothrombin
time. Ultrasound examination proved hepatomegalia with diffusely hyperechogenic liver without
central lesion. Computer tomography confirmed hepatomegalia with diffusely
hyperechogenic liver and a suspicion of liver steatosis was expressed. Liver biopsy confirmed
serious diffuse large droplet steatosis of unclear genesis. Carried out examinations excluded
infectious and autoimmune liver diseases, metabolic diseases, and congenital liver diseases (Wilson
´s disease, porphyria, haemochromatosis etc.). Laboratory results showed gliadin, endomysin,
and reticulin antibodies. An enteroscopy picture showed villi decrease. Histology examination of
a biopsy specimen confirmed total villi atrophy with non-differentiated enterocytes and roundcell
cellulisation of epithelium and proprium. Histology and histochemical findings were distinct
proves of coeliac disease. A patient was prescribed a gluten free diet. Her metabolic parameters
(normalisation of albumine levels, prothrombine time, and trace elements) and anino transferase
levels gradually improved. This case documents development of a serious liver disorder as a result of
malnutrition which developed in a young woman as a result of unrecognised coeliac disease.
Key words:
Coeliac disease - Steatosis - Malabsorption - Malnutrition
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