Case 229

Medical History

Forty-six-year-old male patient, socioeconomically deprived, living in an area of frequent flooding, was attended at the Alfa Institute of Gastroenterology HC-UFMG with dyspeptic symptoms, low fever, unintentional weight loss of 13 kg and intermittent diarrhea without abnormal elements in the stool, for the last five months. Also reported migratory polyarthralgia for about five years. His twin brother (monozygotic) had the same clinical picture. The additional investigation attached was requested.

Image 1: Endoscopic view of the beginning of the second portion of the duodenum.

 

Image 2: Endoscopic view of the second portion of the duodenum.

 

Image 3: Optical microscopy of endoscopic biopsy specimen of the duodenal mucosa. 100x magnification, PAS staining technique.

 

Image 4: Optical microscopy of endoscopic biopsy specimen of the duodenal mucosa. 400x magnification, PAS staining technique.



Question:
Considering the clinical and epidemiological picture and complementary investigation results presented, which is the correct diagnosis?

Leave a Reply