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Question category: Gastroenterology

A 55 year old gentleman presents to his GP with intermittent abdominal pain and diarrhoea which is sometimes difficult to flush away. He has also had a cough, fever and has noticed aches and pains in his joints. A biopsy of the duodenum reveals periodic acid Schiff stain positive macrophages with intracellular clumps. What is the most likely diagnosis?

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