[Endemic sprue: its first diagnosis based on XXXX complications].

@entity1 @entity1944 @entity66 @entity548 @entity2067 @entity1524 @entity4 @entity904 @entity4121 @entity68
HISTORY AND CLINICAL FINDINGS: A 47-year-old @entity1 without previously known illness was admitted to hospital because of acute haematomas in the legs: the history revealed no cause. The pale-looking @entity1 reported having large and foul-smelling stools once or twice daily. There were large haematomas and @entity4 on both legs. His general and nutritional state was reduced. "Bleeding of unknown origin" was suspected at this time. INVESTIGATIONS: @entity4121 concentration was 5.6 g/dl, while @entity68 was normal and ferritin reduced. Quick value was below 5%, activated partial thromboplastin time prolonged to 180 s. @entity904 and E concentrations were reduced; @entity1524 derivatives were not demonstrated in blood. Abdominal ultrasonography showed clearly thickened intestinal walls. TREATMENT AND COURSE: Four units of erythrocyte concentrate were immediately administered, together with 2000 IU factors II, VII, X and anti-haemophilic factor B (PPSB), and 10 mg @entity2067 intravenously. As @entity1944 was suspected, a @entity904 absorption test was performed: it indicated malabsorption. Upper intestinal endoscopy showed @entity66 , as did a biopsy. The @entity1 's state quickly improved after he had been given vitamins A, D, E and K and put on a gluten-free diet. CONCLUSION: @entity66 can take a clinically unremarkable course for a long time and may finally become manifest through an isolated abnormality, such as @entity548 .
