Celiac disease and multiple jejunal diverticulosis

Summary A 60-year-old woman with diarrhea, weight loss, steatorrhea, and anemia was found to have multiple jejunal diverticula and a flat jejunal mucosa on peroral biopsy. Serial metabolic studies and multiple jejunal biopsies conducted during a 40-day period of gluten withdrawal showed a decrease in steatorrhea, a return toward normal of mucosal lipid distribution, and focal improvement in the morphology of the jejunal surface epithelium. During gluten read-ministration, fecal fat excretion increased and the distribution of lipid droplets in the jejunal mucosa again became abnormal. The administration of an antibiotic for 16 days had no effect on the clinical, biochemical, or histologic abnormalities. The results suggest that the malabsorption was attributable to celiac disease and not to the jejunal diverticulosis.Supported in part by Grants FR-00044 from the Division of Research Facilities and HE-06089 from the National Institutes of Health, U. S. Public Health Service.Serum Vitamin B₁₂ and folate determinations were performed by Dr. Frederick A. Klipstein, Columbia University College of Physicians and Surgeons, New York, N. Y., and total lipid assays by Bio-Science Laboratories, Los Angeles, Calif.