<<Disclaimer: Verify this information before applying it to your situation.>> 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