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The University of Calgary's GI Research Group's web page had the following
weekly quiz recently:

>A 28 year old woman presented with a 6 month history of generalized
>weakness and fatigue. Her family doctor noted that she was anemic with
>large red cells (macrocytic anemia). Shown below is a view of the second
>part of her duodenum. What is the diagnosis?

  http://136.159.166.5/1_Jun_1995.htm  [for picture]

>The correct answer is;

>    Celiac Disease

>One of the first thoughts that should come to mind when seeing a young
>patient with macrocytic anemia is malabsorption of either folate or B12.
>In this case the answer was folic acid deficiency and a common cause of
>this is celiac disease or gluten-sensitive enteropathy. The clue to this
>on the endoscopic picture is the typical "scalloping" of the folds best
>seen on the fold at the top of the picture. Instead of the edge being
>smooth it is irregular. The most common presentation of this disease
>would be iron deficiency but the malabsorption of other nutrients such
>as folic acid is not uncommon.

Use http://136.159.166.5/ if you want to start at the top.

Don <[log in to unmask]> New York City