A 4-year-old girl is brought to the physician because her parents noticed that she has been having pale, fatty, foul-smelling stools. The patient is at the 50th percentile for height and 10th percentile for weight. Her symptoms respond dramatically to a gluten-free diet. Which of the following is the most likely diagnosis?
Celiac sprue
Cystic fibrosis of the pancreas
Menetrier disease
Tropical sprue
Celiac sprue, which is also referred to as gluten-sensitive enteropathy, is characterized by (1) generalized malabsorption, (2) small intestinal mucosal lesions, and (3) prompt clinical and histopathologic response to the withdrawal of gluten-containing food. Critical factors in the development of celiac sprue include genetic predisposition and gliadin exposure. The hallmark of celiac disease is a flat mucosa, with blunting of villi, damaged epithelial cells, intra-epithelial T cells, and increased plasma cells in the lamina propria. The other choices do not respond to a gluten-free diet.Diagnosis: Celiac sprue
G.I.T.