Persistent watery diarrhoea and coma in an elderly woman

Abstract

In November, 2010, a 75-year-old woman presented to us with persistent diarrhoea, anorexia, and weight loss. She did not respond to empiric antibiotics or loperamide. She had a history of hypertension, and was being treated with perindopril, autoimmune hypothyroidism treated with thyroxine, and widespread arthrosis. On physical examination, she was in a stable condition, with dry mucous membranes and skin. Stool tests suggested watery diarrhoea. The faecal volume exceeded 1 L per day, and persisted despite fasting.