A48 year old female presented with intermittent episodes of diarrhea, loss of appetite and weight loss. On evaluation she had
Iron deficiency, megaloblastic anemia and hypoalbuminemia causing pedal edema. Inspite of symptomatic treatment for 2
years, her symptoms worsened. Colonoscopy and colonic biopsy were normal. Upper GI scopy was normal. Gastric biopsy showed
H.pylori induced active corporal gastritis. Biopsy from second part of duodenum showed sprue like morphological changes in the
mucosa characterized by broad and shortened villi and intraepithelial lymphocytosis with loss of normal decrescendo pattern.
She was put on anti H.pylori regimen leading to rapid clinical improvement within 2 months of initiating treatment. Hence, the
possibility of H.pylori induced deodenitis should also be considered in the differential diagnosis of chronic diarrhoeal diseases.
Dr Bhavna Nayal has completed her MD in Pathology in the year 2010 at the age of 28 years from Manipal University, India. She is presently
working as Assistant professor in Pathology in Kasturba Medical College, Manipal, Manipal University. She has special interest in the field of Surgical
pathology and also has experience in Haematology and HLA typing. She has published around 15 papers in reputed journals. In the current position
she holds additional responsibilities of overseeing overall performance and maintenance of the HLA laboratory and is an acting member of the ISO
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