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Question category: Gastroenterology

A 35 year old male who has lived in Barbados for the last few years presents with diarrhoea, which sometimes difficult to flush away. This has caused about 5 kg weight loss. He is very fatigued and feverish at times. He has also noticed some ankle oedema. On examination he looks cachectic. Bloods reveal a macrocytic anaemia, low potassium and calcium levels and albumin levels. A jejunal biopsy reveals incomplete villous atrophy and inflammatory infiltrate. What is the most likely diagnosis?

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