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Celiac Disease and Geographic (Serpiginous) Choroidopathy With Occurrence of Thrombocytopenic Purpura

Chris J. J. Mulder, MD; A. Salvador Pena, MD; Jan Jansen, MD; Jendo A. Oosterhuis, MD
Arch Intern Med. 1983;143(4):842. doi:10.1001/archinte.1983.00350040232043.
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To the Editor.  —In the May Archives (1982;142:1037), Eliakim et al described one patient with celiac disease, keratoconjunctivitis, and autoimmune thrombocytopenic purpura (ATP) with HLA antigens B8 and Dw3. We report another case of celiac disease and ATP associated with geographic (serpiginous) choroidopathy.

Report of a Case.  —A 45-year-old man was admitted to the hospital in March 1972 for evaluation of a 5-kg weight loss and intermittent diarrhea during the past months. Physical examination findings were normal. Hemoglobin level was 13 g/L, leukocyte count was 6×109/L, and platelet count was 300×109/L. Stool fat excretion was 20 g/24 hr, xylose excretion was 0.95 g/5 hr, serum albumin level was 4.5 g/dL, and calcium level was 10 mg/dL. A roentgenogram of the small bowel showed no abnormalities. A small intestinal biopsy specimen showed a severe partial villous atrophy, which reverted to normal following a gluten-free diet. Challenge with


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