Three male Shar-pei dogs and one female spayed Boxer dog ranging in age from 4 years, 4 months to 7 years, 8 months had 4-7-week histories of diarrhea, progressive anorexia, weight loss, and vomiting. The dogs were depressed, lethargic, and hypoalbuminemic, with losses of 23-39% of body weight. Endoscopic examination revealed gastric ulceration with areas of mucosal hyperemia and pallor. Small nodules with occasional central depressions were present in three dogs. Gastric and proximal duodenal mucosal biopsies showed neoplastic lymphocytes infiltrating the lamina propria, with invasion of the superficial and glandular epithelial basement membrane. Immunohistochemical evaluation of two dogs was negative for anti-canine IgG and positive for anti-CD3. Necropsy of the Boxer and two Shar-peis confirmed epitheliotropic gastric and small intestinal lymphoma in all three dogs, with mesenteric lymph node and hepatic involvement in two and one dog, respectively.
The gluten content and nutritional adequacy of the diet of a group of adult coeliac patients supposedly following a gluten-free diet for at least one year were assessed. Results were considered in relation to the nutritional state of these patients, determined by anthropometric measurement, and the histological appearance of jejunal biopsies taken at the time of nutritional assessment. Imperfect gluten avoidance, mild malnutrition and mild histological abnormalities on jejunal biopsy were frequent findings. A careful dietary and nutritional assessment when considered in light of histological findings at jejunal biopsy helps to identify the causes of persisting symptoms or malnutrition in treated coeliac patients. A normal jejunal biopsy in a malnourished patient whose dietary compliance is good should prompt a search for an alternative diagnosis.
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