- severe malabsorption (2 or more substance) accompanied by diarrhea and malnutrition
- presents with diarrhea, anorexia, abdominal distension, weight loss and steatorrhea
- work up : detailed history (travel history), D-xylose absorption test, jejunal biopsy (blunting/atrophy of villi, with subepithelial lymphocytic infiltration)
- megaloblastic anemia in more than 50% of cases
- treatment : folic acid supplementation, IM vitamin B12, tetracycline for 6 months
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