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We read with interest the article by Troeger et al exploring the epithelial barrier dysfunction related to duodenal Giardia lamblia infection (Gut 2007;56:328–35). Not only does this protozoan interact with the intestinal epithelium but also its life cycle depends on its host’s bile metabolism.
We report here on a patient for whom treatment with fibrate was likely to facilitate Giardia lamblia colonic colonisation. A 72-year-old woman reported a 1-year history of diarrhoea. She had a past history of type 2 diabetes, hypertension and hypercholesterolaemia. She was treated with metformin, glimepiride, enalapril, furosemide and fenofibrate. She had had a 30 kg loss of weight in the past year (from 90 to 60 kg, 157 cm) but no haematochezia, vomiting or abdominal pain.
A physical examination was normal. Repeated glycaemic controls and haemoglobin A1c were deemed satisfactory. Further laboratory …
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