We present the case of a 43-year-old female. Shortly after birth, she presented a spontaneous right hip fracture. From then, until now, she has had multiple fractures of both arms and legs, which have required several interventions for correction, needing on the left humerus to be fixed with a medullary locking (Figure 1). The last fracture episode happened 3 years ago. OI type 2 was diagnosed, 20 years ago. For moving at home, she walks with difficulty with a cane, and, on the street, she is moved by wheelchair. She presents a significant growth delay (High = 1'14 m) and weighed 65 kg, presenting a picture of morbid obesity, with an increased body mass index (BMI = 45.4 kg/m2).
She relates that for about 2 years, and she has slow digestion, accompanied by marked abdominal bloating, accompanied by heartburn and reflux. The major alteration in her bowel habit was an alternating pattern with diarrhea and constipation. The patient had also bilateral hearing loss, requiring hearing aids for ten years.
Currently, the CBC was normal. Blood glucose was elevated (230 mg/dL) with increased glucosuria (4+). The rest of biochemical analysis was normal. She underwent a gastroscopy that showed a moderate reflux oesophagitis (grade B Angeles classification) without associated hiatal hernia. Duodenal biopsies showed an increased intraepithelial lymphocytosis (45%) corresponding to stage I of affordable Marsh. Genetic markers of CD type DQ2 were positive in homozygosis, and antibodies to tissue transglutaminase (tTG) were normal (0.6 U/mL). Antinuclear antibodies were negative. Vitamin D deficiency was excluded.
She was started on a gluten-free diet (GFD) and an oral antibiotic drug, type Metformine-850 mg/twice daily was given, having lost 6 kg of weight in 6 months with good control of DM-II and presenting a significantly improvement related to the presence of prior digestive problem. A recently completed study of bone mineral density (BMD) has been reported as normal.