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Case Reports
. 2025 Feb 16;18(2):e262400.
doi: 10.1136/bcr-2024-262400.

Coeliac disease masquerading as macroamylasaemia

Bashayer Al-Rufayi  1 , Abdulmalik M Alsabban  2 , Abbas A Zagnoon  1
Affiliations
Case Reports

Coeliac disease masquerading as macroamylasaemia

Bashayer Al-Rufayi et al. BMJ Case Rep. .

Abstract

Macroamylasaemia (MA) is a biochemical disorder characterised by elevated serum amylase activity, resulting from the circulation of a macromolecular complex of amylase bound to a serum component, often an immunoglobulin. The increased molecular weight of this complex prevents the normal renal excretion of the enzyme. A few cases of adult patients with coeliac disease (CD) and MA have been reported, in which the biochemical disorder resolved after treatment with a gluten-free diet. However, in other cases, this resolution did not occur. Here, we report a case of CD masquerading as recurrent pancreatitis due to the presence of MA.

Keywords: Coeliac disease; Gastrointestinal system; Small intestine.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1. Endoscopic images of the duodenum.
Figure 2
Figure 2. Low-power view of multiple duodenal biopsies showing an area of total villous atrophy (red arrow) and an area with significant villous shortening (black arrow).
Figure 3
Figure 3. Heavy lymphocyte infiltration of the enterocytes, highlighted by H&E staining (A) and CD3 immunostaining (B).
See this image and copyright information in PMC

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