Tariq Butt, Rifat Nadeem Ahmad, Syed Yousaf Kazmi, Raja Kamran Afzal, Muhammad Jan Leghari.
Cryptosporidiosis in a case of coeliac disease.
Pak Armed Forces Med J Jan ;55(1):84-5.

A 10 years old boy was admitted with history of chronic, often severe diarrhoea for the last five years. Two years earlier he had been diagnosed as a case of celiac disease and put on gluten-free diet. Although, his condition improved appreciably; six months later diarrhoea recurred. His condition deteriorated progressively as the severity of diarrhoea increased. At the time of admission to the hospital, he appeared pale, emaciated and pot-bellied, and had marked splenomegaly. He was passing 6-8 large volume watery stools per day. Histopathologic examination of the biopsy showed villous atrophy with lymphocytic infiltration in the lamina propria, while microscopic examination of the duodenal fluid smear after modified Ziehl Neelsen (ZN) acid-fast staining showed oocysts of cryptosporidium. The oocysts were also seen on subsequent microscopic examination of faecal smear after modified ZN staining. The patient was administered oral metronidazole in a dose of 30mg/kg body weight every eight hours for ten days along with iron and vitamin supplements. His diarrhoea soon subsided and he was discharged from the hospital with advice to continue gluten-free diet. The patient has made remarkable recovery and on follow up three months later he was found healthy, active and symptom-free.

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