PMC4435370_01
(A) Duodenal bulb showing mucosal nodularity and erosions on endoscopy. (B) Second part of the duodenum showing total loss of mucosal folds on endoscopy. (C) Terminal ileum showing ileal mucosal atrophy on endoscopy.
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F1
Esophagogastroduodenoscopy and ileoscopy revealed duodenal bulb erosions and mucosal nodularity (Figure 1A), total loss of mucosal folds in the second part of the duodenum (Figure 1B), and absence of villi and of granularity in the terminal ileum (Figure 1C).
(A) Duodenal biopsy showing total villous atrophy and hypoplasia (Marsh IV). (B) Ileal biopsy showing villous atrophy. (C) Colonic biopsy revealing microscopic colitis.
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F2
IV) with greater than 50 lymphocytes per 100 epithelial cells and crypt hyperplasia (Figure 2A). Ileal biopsies also showed villous atrophy (Figure 2B), and random colonic biopsies showed lymphocytic colitis (Figure 2C).