Fig. 7.

Duodenal biopsy from an 18-year-old female with a diffuse autoimmune disorder with thyroiditis, a protein-losing enteropathy and positive anti-enterocyte antibodies. There is partial villous atrophy and a milder inflammatory infiltrate as compared to the previous figure. This biopsy was initially interpreted as consistent with celiac disease. The patient had negative celiac serology and did not respond to a gluten-free diet. There is mild intraepithelial lymphocytosis; however, the absence of goblet and Paneth cells noted in this case is not a feature of celiac enteropathy