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A 20-year-old man with no significant medical history presented with a 5-day history of intermittent chest pain and dyspnoea. He also reported a 3-month history of daily diarrhoea characterised by multiple, loose, watery, non-bloody stools. Physical examination was notable for tachycardia and a soft systolic murmur at the apex. Laboratory evaluation was significant for microcytic anaemia (serum iron 17 μg/dL; normal range 50–150 μg/dL) and an NT-proBNP (N-terminal pro-brain natriuretic peptide) of 18 995 pg/mL (normal <51 pg/mL). A colonoscopy with random biopsies for evaluation of diarrhoea was unremarkable. Esophagogastroduodenoscopy demonstrated a scalloped and mosaic pattern in the second and …
Contributors BA and SR: Design, acquisition of data and drafting of manuscript. GL and VN: Drafting of manuscript and critical revision of the manuscript for important intellectual content.
Competing interests None.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.
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