Refractory disease, symptom mimics, and confounding comorbidities complicate these 3 cases. Can you tease out the answers?
Thirty percent of patients diagnosed with celiac disease continue to report symptoms despite being on a gluten-free diet, a significant concern as there is 2-4 times increased risk of coronary artery disease and small bowel cancers associated with the condition. What is the best remedy for refractory symptoms? Celiac disease also has clinical and histologic similarities to other enteropathies which can delay definitive diagnosis -- and approriate treatment.These issues and others are included in the 3 case challenges that follow below. Find out what you know about celiac disease.