{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T19:35:27Z","timestamp":1757619327164,"version":"3.44.0"},"reference-count":5,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Frontline Gastroenterol"],"accepted":{"date-parts":[[2018,5,10]]},"published-print":{"date-parts":[[2019,1]]},"abstract":"A 62-year-old man presented to the emergency department with 5\u2009weeks of worsening lower abdominal pain associated with watery diarrhoea, vomiting and 10% loss of body weight. He had recently experienced night blindness.<\/jats:p>\n There was no history of foreign travel. His past medical history included hypertension, sickle cell trait and type 2 diabetes well controlled on metformin. He had not been prescribed any recent steroids and denied significant alcohol intake.<\/jats:p>\n On examination, he had a tachycardia at 110 bpm and was afebrile and normotensive. He was malnourished with pedal pitting oedema extending to both knees. His abdomen was soft but distended and diffusely tender.<\/jats:p>\n Blood tests showed a serum albumin of 12\u2009g\/L. Stool samples were negative. HIV testing was negative, and immunoglobulin levels were normal.<\/jats:p>\n CT of the abdomen showed thickened, hyperenhancing jejunal loops with diffuse mesenteric inflammatory fat stranding and enlarged mesenteric lymph nodes. Colonoscopy was unremarkable.<\/jats:p>\n Enteroscopy showed granular oedematous mucosa and extensive, deep ulcerations. Jejunal biopsies were obtained. Microscopy samples were negative for tuberculosis (TB) culture.<\/jats:p>\n Histology revealed inflamed and ulcerated small bowel mucosa with plump endothelial cells with the appearance below. There were no granulomata (figures 1 and 2).\n\n Figure 1<\/jats:label>\n \n Endoscopic examination of the jejunum.<\/jats:p>\n <\/jats:caption>\n \n <\/jats:fig>\n \n Figure 2<\/jats:label>\n \n Plump endothelial cells seen on microscopy.<\/jats:p>\n <\/jats:caption>\n \n <\/jats:fig>\n <\/jats:p>\n \n Question<\/jats:title>\n What is the differential diagnosis?<\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/flgastro-2018-100996","type":"journal-article","created":{"date-parts":[[2018,6,28]],"date-time":"2018-06-28T12:31:33Z","timestamp":1530189093000},"page":"56-56","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["An unusual cause of intestinal failure"],"prefix":"10.1136","volume":"10","author":[{"given":"Gavin Alistair","family":"Stead","sequence":"first","affiliation":[{"name":"Department to Gastroenterology, University Hospital Lewisham, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ben","family":"Warner","sequence":"additional","affiliation":[{"name":"Department to Gastroenterology, University Hospital Lewisham, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Clough","sequence":"additional","affiliation":[{"name":"Department to Gastroenterology, University Hospital Lewisham, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Effie","family":"Lanaspre","sequence":"additional","affiliation":[{"name":"Department of Pathology, University Hospital Lewisham, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"O\u2019Donohue","sequence":"additional","affiliation":[{"name":"Department to Gastroenterology, University Hospital Lewisham, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,6,28]]},"reference":[{"doi-asserted-by":"publisher","key":"2025090709242494000_10.1.56.1","DOI":"10.1097\/00000441-197811000-00010"},{"doi-asserted-by":"publisher","key":"2025090709242494000_10.1.56.2","DOI":"10.7326\/0003-4819-107-2-133"},{"key":"2025090709242494000_10.1.56.3","doi-asserted-by":"crossref","first-page":"5957","DOI":"10.2174\/0929867311209065957","article-title":"Cytomegalovirus prophylaxis in solid organ transplantation","volume":"19","author":"Alexopoulos","year":"2012","journal-title":"Curr Med Chem"},{"unstructured":"Cytomegalovirus. http:\/\/patient.info\/doctor\/cytomegalovirus (accessed 19 Dec 2016).","key":"2025090709242494000_10.1.56.4"},{"doi-asserted-by":"publisher","key":"2025090709242494000_10.1.56.5","DOI":"10.1016\/j.jiac.2013.12.004"}],"container-title":["Frontline Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/flgastro-2018-100996","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,7]],"date-time":"2025-09-07T16:24:32Z","timestamp":1757262272000},"score":1,"resource":{"primary":{"URL":"https:\/\/fg.bmj.com\/lookup\/doi\/10.1136\/flgastro-2018-100996"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,6,28]]},"references-count":5,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2018,12,7]]},"published-print":{"date-parts":[[2019,1]]}},"alternative-id":["10.1136\/flgastro-2018-100996"],"URL":"https:\/\/doi.org\/10.1136\/flgastro-2018-100996","relation":{},"ISSN":["2041-4137","2041-4145"],"issn-type":[{"type":"print","value":"2041-4137"},{"type":"electronic","value":"2041-4145"}],"subject":[],"published":{"date-parts":[[2018,6,28]]}}}