Thanks to Jacques Cornuz and colleagues1 for reporting the case of fatigue in primary care. Studies here in Australia have highlighted the need for a thorough history and targeted laboratory testing, although most test results will be “normal.”2
I am interested in what happened next in this case. The woman had laboratory features for celiac disease, but was this the cause of her symptoms? After the biopsy, did she start a gluten-free diet and then undergo another biopsy? Did she feel better on a gluten-free diet? If not, then we still do not have an adequate explanation for her symptoms. We, the physicians, have “treated” ourselves but not the patient.
REFERENCES
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