In November, 2010, a 75-year-old woman presented to us with persistent diarrhoea, anorexia, and weight loss. She did not respond to empiric antibiotics or loperamide. She had a history of hypertension, and was being treated with perindopril, autoimmune hypothyroidism treated with thyroxine, and widespread arthrosis. On physical examination, she was in a stable condition, with dry mucous membranes and skin. Stool tests suggested watery diarrhoea. The faecal volume exceeded 1 L per day, and persisted despite fasting. Stool parasitological examination and culture were negative. Upper gastrointestinal endoscopy and colonoscopy were done immediately and were normal so a biopsy sample was not taken. Laboratory tests showed mild normochromic, microcytic, anaemia (haemoglobin 110 g/L), hypo-natraemia, and persistent hypokalaemia. C-reactive protein was 47 mg/L, total protein 50 g/L, and albumin was 27 g/L. Serum protein electrophoresis showed an irregular gamma profile. Serum iron and ferritin were normal, and transferrin was low 1-03 g/L, (normal range 2-3-6). Total cholesterol and HDL cholesterol concentrations were low (2-28 mmol/L and 0 ? 44mmol/L). Tryglicerides were normal. An HIV test was negative. Serological investigation for coeliac disease was negative, and total IgA was normal.
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机译：2010年11月，一名75岁的女性向我们展示了持续的腹泻，厌食和体重减轻。她对经验性抗生素或洛哌丁胺没有反应。她有高血压病史，正在接受培哚普利治疗，甲状腺素治疗的自身免疫性甲状腺功能减退症和广泛的关节病。经身体检查，她的病情稳定，粘膜和皮肤干燥。粪便检查提示水样腹泻。每天的粪便量超过1 L，尽管禁食仍持续存在。大便寄生虫学检查和培养均为阴性。立即进行上消化道内窥镜检查和结肠镜检查，结果均正常，因此未取样。实验室检查显示轻度正常色素性，小细胞性，贫血（血红蛋白110 g / L），低钠血症和持续性低钾血症。 C反应蛋白为47 mg / L，总蛋白为50 g / L，白蛋白为27 g / L。血清蛋白电泳显示不规则的伽马曲线。血清铁和铁蛋白正常，转铁蛋白低1-03 g / L（正常范围2-3-6）。总胆固醇和HDL胆固醇浓度较低（2-28 mmol / L和0？44mmol / L）。 Tryglicerides正常。艾滋病毒检测呈阴性。腹腔疾病的血清学检查为阴性，总IgA正常。
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