PMC4435362_01
Small bowel biopsy on valsartan and a gluten-free diet for 5 years showing a malabsorption pattern with partial villous atrophy, with crypt hyperplasia and inflammation with 100 intraepithelial lymphocytes per 100 epithelial cells.
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F1
Celiac disease was suspected based on duodenal and jejunal biopsies showing complete villous atrophy, intraepithelial lymphocytosis, and crypt hyperplasia (Figure 1).
Fissuring and scalloping with blunted villi shown on capsule endoscopy. Extensive villous atrophy affecting approximately 75-90% of the small intestinal mucosa based on time.
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F2
Capsule endoscopy showed scalloping, blunted villi, and extensive villous atrophy in 75-90% of the small intestine, based on time (Figure 2).
Normal duodenal mucosa on biopsy 1 year following cessation of valsartan while consuming gluten-containing diet.
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F3
Repeat duodenal biopsy 1 year following medication cessation demonstrated normalization of her villous architecture (Figure 3).