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Hypoalbuminaemia and coeliac disease
1 Department of Gastroenterology, Box Hill Hospital, Victoria, Australia
2 Department of Radiology, The Royal Melbourne Hospital, Victoria, Australia
3 Department of Surgery, Box Hill Hospital, Victoria, Australia
4 Department of Pathology, Box Hill Hospital, Victoria, Australia
5 Department of Medicine, Monash University, Victoria, Australia
Correspondence to:
Professor P Gibson, Department of Medicine, Box Hill Hospital, Box Hill, Victoria 3128 Australia; peter.gibson@med.monash.edu.au
| The first 150 words of the full text of this article appear below. |
CLINICAL PRESENTATION
A 23-year-old woman was diagnosed with coeliac disease with positive serology and typical duodenal histology. A gluten-free diet was instituted. About 9 months later, she presented with bipedal oedema that developed overnight, associated with a fall in serum albumin from 48 g/l to 25 g/l. There were no abdominal symptoms. Haematology, 24 h urinary albumin excretion and a small bowel barium study were normal. Inadvertent gluten ingestion was identified at formal review by a dietitian, leading to dietary re-education. The albumin subsequently normalised.
She represented—this time without inadvertent gluten ingestion—3 months later in the same fashion. Her serum albumin had dropped to 25 g/l but other blood tests were normal. Jejunoscopy and colonoscopy were normal. A CT scan of the abdomen and pelvis was performed (fig 1), followed by MRI (fig 2).
Figure 1 CT scan of the abdomen.
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Figure 2 MRI of the abdomen showing T1- and T2-weighted images | |||||||||
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ANSWER
Gut 2008 57: 930.[Extract] [Full Text] [PDF]
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