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Intestinal lymphangiectasia masquerading as coeliac disease
H M Nazer1, H Abutalib, C Hugosson
1Department of Pediatrics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Annals of Tropical Paediatrics
|January 1, 1991
Summary
Intestinal lymphangiectasia (IL) can mimic celiac disease, delaying diagnosis. A medium-chain triglyceride diet effectively treated three children with IL, improving their symptoms.
Area of Science:
- Gastroenterology
- Pediatrics
- Medical Diagnostics
Background:
- Intestinal lymphangiectasia (IL) often presents with vague symptoms, leading to diagnostic delays.
- IL can mimic other gastrointestinal disorders, complicating accurate and timely diagnosis.
- Delayed diagnosis of IL can result in prolonged and ineffective treatments for other conditions.
Observation:
- Three pediatric patients initially diagnosed with celiac disease were later diagnosed with IL.
- Two sisters with IL showed no improvement on a gluten-free diet for 3 and 10 years.
- A third patient experienced failure to thrive, edema, abdominal distension, and infections before IL diagnosis.
Findings:
- Diagnosis of IL was confirmed through clinical history, physical examination, and radiological/histological findings.
- All three pediatric patients with IL responded well to a medium-chain triglyceride-based diet and vitamin supplementation.
- The dietary intervention led to satisfactory clinical outcomes for the diagnosed patients.
Implications:
- Highlights the importance of considering IL in pediatric patients with refractory gastrointestinal symptoms.
- Suggests that a medium-chain triglyceride-based diet is an effective treatment for intestinal lymphangiectasia.
- Emphasizes the need for comprehensive diagnostic approaches to avoid misdiagnosis and delayed treatment in pediatric GI disorders.