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Colonic colonisation with Giardia lamblia in a patient receiving fibrates
  1. X Dray1,
  2. V Medeau2,
  3. M Qubaja3,
  4. A Lavergne-Slove3,
  5. P J Guillausseau4,
  6. P Marteau5
  1. 1
    Département de Pathologie Digestive, AP-HP, Hôpital Lariboisière, Paris 7 University, Paris, France
  2. 2
    Service de Médecine B, AP-HP, Hôpital Lariboisière, Paris 7 University, Paris, France
  3. 3
    Service d’Anatomie et Cytologie Pathologiques, AP-HP, Hôpital Lariboisière, Paris 7 University, Paris, France
  4. 4
    Service de Médecine B, AP-HP, Hôpital Lariboisière, Paris 7 University, Paris, France
  5. 5
    Département de Pathologie Digestive, AP-HP, Hôpital Lariboisière, Paris 7 University, Paris, France
  1. Dr X Dray, Département de Pathologie Digestive, Hôpital Lariboisière, 2, rue Ambroise Paré, 75010 Paris, France; xavier.dray{at}lrb.aphp.fr

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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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