Diabetic microangiopathy in the small bowel

Aims: Microangiopathic changes in the gastrointestinal tract of patients wi th diabetes mellitus are frequently mentioned in the clinical literature, T o our knowledge, pathological studies documenting these changes in bowel bi opsies have not been previously reported. In this report, we describe strik ing duodenal biopsy findings of diabetic microangiopathy in a patient with long-standing insulin-dependent diabetes mellitus and chronic diarrhoea. Methods and results: The diagnosis was based on the histopathological and i mmunohistochemical findings in the appropriate clinical setting, Blood vess els within the duodenum displayed prominent mural thickening and luminal na rrowing secondary to accumulation of hyaline material, which was periodic a cid-Schiff positive and intensely stained with monoclonal antibodies agains t type TV collagen. Conclusions: This is the first report of diabetic microangiopathy in a bowe l biopsy The pathogenesis, specificity and significance of these angiopathi c changes, controversies about diabetic microangiopathy in the gastrointest inal tract, and the association with hypertension are discussed.