Which of the following is NOT part of the five diagnostic criteria for steroid-responsive enteropathy?

• A. Chronic GI signs for >3 weeks
• B. Histopathologic evidence of intestinal mucosal inflammation
• C. Exclusion of other underlying causes
• D. Positive response to probiotic therapy

Answer: (D)

Steroid-responsive enteropathy is defined by a pattern of chronic inflammatory intestinal disease that shows a clear response to corticosteroids. The diagnostic picture relies on long-standing GI signs, histopathologic evidence of mucosal inflammation, and a careful exclusion of other causes of enteropathy. A positive response to steroid therapy is the hallmark that distinguishes this condition. A positive response to probiotic therapy, while helpful as supportive care for gut health, does not define or confirm steroid responsiveness and isn’t used as part of the diagnostic criteria. Therefore, probiotic response is not part of the five criteria.