UNDEFINED MALABSORPTION-SYNDROME WITH VILLOUS ATROPHY SUCCESSFULLY REVERSED BY TREATMENT WITH CYCLOSPORINE

A 47-year-old man with a flat jejunal mucosa complicated by malabsorpt ion, diarrhoea and lymphocytic colitis is presented. There was no resp onse to gluten withdrawal alone, combination of a gluten-free diet and prednisone therapy, or total parenteral nutrition. Complete clinical remission was only achieved after simultaneous treatment with cyclospo rine and a gluten-free diet. Rechallenge with a gluten-containing diet while cyclosporine treatment continued resulted in a relapse of diarr hoea and malabsorption. We conclude that cyclosporine may be an effect ive agent for the treatment of undefined, refractory forms of malabsor ption.