Chronic diarrhea has a broad differential diagnosis, but careful evaluation of extraintestinal manifestations can often lead to a specific etiology. Match each patient's clinical presentation of chronic diarrhea and systemic symptoms with the most likely underlying diagnosis.
- A 42-year-old man presents with chronic watery diarrhea and recurrent abdominal pain. Upper endoscopy reveals multiple duodenal ulcers and prominently thickened gastric folds.Zollinger-Ellison syndrome
- A 35-year-old woman presents with chronic diarrhea, fatigue, and an intensely pruritic, grouped vesicular skin eruption on her extensor surfaces. Laboratory studies show microcytic anemia.Celiac disease
- A 50-year-old man presents with chronic diarrhea, significant unintentional weight loss, migratory large-joint arthralgias, and recent-onset memory impairment.Whipple disease
- A 28-year-old woman presents with episodic watery diarrhea, paroxysmal facial flushing, intermittent wheezing, and a newly appreciated right-sided systolic heart murmur.Carcinoid syndrome
Cevap
The correct matches pair each distinct systemic presentation of chronic diarrhea with its underlying etiology: Zollinger-Ellison syndrome (acid hypersecretion), Celiac disease (dermatitis herpetiformis), Whipple disease (arthralgias and cognitive decline), and Carcinoid syndrome (flushing and right-sided murmur).
Each patient's clinical vignette contains highly specific systemic manifestations that narrow the broad differential diagnosis of chronic diarrhea down to a single unifying diagnosis. Identifying these key extraintestinal signs is essential for accurate diagnosis and management.
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Formulating a differential diagnosis for chronic diarrhea based on distinct extraintestinal manifestations.
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