Adult-Onset Autoimmune Enteropathy Mimicking Disaccharidase Deficiency
Bibliographic record
Abstract
Adult-onset autoimmune enteropathy is a rare disorder characterized by severe diarrhea, weight loss, malnutrition, and enteric mucosal atrophy resulting from immune-mediated injury. Disaccharidase deficiencies are a group of disorders characterized by inadequate activity of disaccharidase in the small intestine, leading to impaired digestion of disaccharides and malabsorption. Here, we present a case of adult-onset autoimmune enteropathy initially diagnosed as disaccharidase deficiency based on the clinical symptoms of chronic diarrhea, weight loss, and severely reduced levels of lactase, maltase, palatinase, and sucrase in duodenal aspirates. However, follow-up duodenal biopsy revealed markedly villous blunting, goblet and Paneth cell depletion, increased crypt apoptotic bodies and lamina propria lymphoplasmacytic inflammation, leading to a revised diagnosis of autoimmune enteropathy. This case highlights the diagnostic challenges of adult-onset autoimmune enteropathy and the importance of considering it in adults with unexplained gastrointestinal symptoms. It also emphasizes the need for tissue biopsies in cases with inconclusive initial diagnostic tests. Increased awareness of these disorders and their mimickers can improve diagnosis and management, ultimately benefiting patients with these conditions.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".