Clinical presentation A 52-year-old man presented with a 6-month history of diarrhoea and unintentional weight loss of 20 kg. During this period, he reported 2 - 3 daily episodes of watery stools with intermittent epigastric distension.
On admission, his body mass index (BMI) was 14.9 kg/m² (height 1.65 m; weight 40.5 kg). He was not on any chronic medications.
Laboratory investigations revealed haemoglobin of 90 g/L, serum total protein of 47.1 g/L and albumin of 22.6 g/L. C reactive protein was 73.3 mg/L.
Immunoglobulin M (IgM) was 34.5 g/L (normal range: 0.5 - 2.2 g/L) and β2-microglobulin was 4949 ng/mL (normal range: 955 - 2157 ng/mL). White blood cell count, platelets, coagulation profile, renal function and lactate dehydrogenase were unremarkable.
Anti-nuclear antibody, extractable nuclear antigen panel and the interferon-gamma release assay were negative. Urinalysis was negative for protein.
Stool tests showed calprotectin 110 µg/g (normal range: 0 - 75 µg/g), positive occult blood and negative cultures. The abdominal CT scan showed no significant abnormalities.
Gastroscopy revealed diffuse white patch-like lesions...
Gut (BMJ) published a clinical update in Research Highlights on 07 Apr 2026.
The item focuses on Cause of chronic diarrhoea.
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