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A 61-year-old male patient presented with a 5-month history of diarrhoea (15 liquid stools per day), diffuse abdominal tenderness and a 10 kg weight loss. He was treated for HIV infection, with undetectable viral load and normal CD4 count (1200/mm³). The patient had not started any new medication. He had no extraintestinal symptoms. Physical examination was otherwise normal, specifically finding no skin or neurological abnormality, and no thrombosis. Stool examination showed no bacterial or parasitic pathogen. Complete blood count, electrolytes, creatinine, vitamin B12 and ferritin levels were normal. Protein electrophoresis showed hypoalbuminaemia (26.0 g/L), but gamma globulins were slightly elevated (13.5 g/L). A monoclonal IgM kappa peak (9.9 g/L) was found. Further …
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, conduct, reporting or dissemination plans of this research.
Provenance and peer review Not commissioned; externally peer reviewed.
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