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Tropical sprue

Thomas C Smyrk
Celiac disease features duodenal intraepithelial lymphocytosis with or without villous atrophy. Lymphocytosis without villous atrophy will be proven to represent celiac disease in 10% to 20% of cases. The differential diagnosis is broad: Helicobacter pylori gastritis, NSAID injury and bacterial overgrowth are considerations. Lymphocytosis with villous atrophy is very likely to be celiac disease, but there are mimics to consider, including collagenous sprue, tropical sprue, drug injury, and common variable immunodeficiency...
December 2017: Surgical Pathology Clinics
Uday C Ghoshal
A decade after Rome III, in 2016, Rome IV criteria were published. There are major differences between Rome IV and the earlier iteration, some of which are in line with Asian viewpoints. The clinical applicability of the Rome IV criteria of irritable bowel syndrome (IBS) in Asian perspective is reviewed here. Instead of considering functional gastrointestinal disorders (FGIDs) to be largely psychogenic, Rome IV suggested the importance of the gut over brain ("disorders of gut-brain interaction" not "brain-gut interaction")...
July 30, 2017: Journal of Neurogastroenterology and Motility
Uday C Ghoshal, Kok-Ann Gwee
Evidence is emerging that IBS, a hitherto enigmatic disorder thought to be predominantly related to psychological factors, has a microorganic basis in a subset of patients with the disease. Post-infectious IBS (PI-IBS), commonly of the diarrhoea-predominant subtype (defined as new development of IBS following acute infectious diarrhoea), is one such condition known to occur in up to 10-30% individuals after acute gastroenteritis. However, following acute infectious gastroenteritis, patients can also develop post-infectious malabsorption syndrome (PI-MAS), popularly known as tropical sprue...
July 2017: Nature Reviews. Gastroenterology & Hepatology
Prasenjit Das, Ramakant Rawat, Anil K Verma, Geetika Singh, Archana G Vallonthaiel, Rajni Yadav, Gaurav P S Gahlot, Amit K Dinda, Vineet Ahuja, Siddhartha Datta Gupta, Sanjay K Agarwal, Govind K Makharia
Tissue transglutaminase 2 enzyme plays a diverse role in intracellular and extracellular functioning. Aberrant expression of anti-TG2 antibody has recently been proposed for extraintestinal identification of celiac disease (CeD), but its utility is questionable. To examine whether anti-TG2 immunohistochemical (IHC) staining can be of diagnostic value in identifying extraintestinal involvement in CeD, tissue blocks of patients with IgA nephropathies (IgAN), minimal change disease, membranous glomerulonephritis, membrano-proliferative glomerulonephritis, normal kidney, intestinal biopsies from CeD, tropical sprue, nonspecific duodenitis, and inflammatory bowel disease; liver biopsies from patients with chronic hepatitis B and C, acute liver failure (ALF), and CeD-associated liver diseases were retrieved and subjected to IHC staining for anti-tissue transglutaminase 2 enzyme...
October 7, 2016: Applied Immunohistochemistry & Molecular Morphology: AIMM
Rashmi Patnayak, Vaikkakara Suresh, Amitabh Jena, Kadiyala Madhu, Bobbit Venkatesh Phaneendra, Venkatrami Reddy
Malabsorption syndrome (MAS) is a common condition in India. In Indian adults, tropical sprue and celiac disease are leading causes of MAS. Sometimes, the diagnosis of MAS may pose a challenge due to the varied signs and symptoms. We present a case of MAS in a young female, whose presenting symptoms were mainly neurological. She was successfully treated under regular follow-up for the past 6 years without any symptoms.
January 2016: Journal of Pediatric Neurosciences
Nina Burbure, Benjamin Lebwohl, Carolina Arguelles-Grande, Peter H R Green, Govind Bhagat, Stephen Lagana
Sprue-like enteropathy associated with the angiotensin II receptor blocker (ARB) olmesartan was first described in 2012, and a number of cases have since been reported. This syndrome is characterized by severe diarrhea and sprue-like histopathologic findings in the intestine, often with increased subepithelial collagen. The incidence of this adverse drug reaction is not entirely clear, although it is thought to be rare. It is also not well established if other ARBs cause such a syndrome, although case reports suggest they can...
April 2016: Human Pathology
Nirav Pipaliya, Meghraj Ingle, Chetan Rathi, Prateik Poddar, Nilesh Pandav, Prabha Sawant
BACKGROUND/AIMS: This study aimed to document the recent etiological spectrum of chronic diarrhea with malabsorption and also to compare features that differentiate tropical sprue from parasitic infections, the two most common etiologies of malabsorption in the tropics. METHODS: We analyzed 203 consecutive patients with malabsorption. The etiological spectrum and factors that differentiated tropical sprue from parasitic infections were analyzed. RESULTS: The most common etiology was tropical sprue (n=98, 48...
January 2016: Intestinal Research
Muhammad Saboor, Amtuz Zehra, Khansa Qamar, Moinuddin
Malabsorption is a disorder of the gastrointestinal tract that leads to defective digestion, absorption and transport of important nutrients across the intestinal wall. Small intestine is the major site where most of the nutrients are absorbed. There are three main mechanisms of malabsorption; premucosal, mucosal and postmucosal. Premucosal malabsorption is the inadequate digestion due to improper mixing of gastrointestinal enzymes and bile with chyme. This could be because of surgical resection of the small intestine or a congenital deficiency of the enzymes and bile responsible for digestion e...
November 2015: Pakistan Journal of Medical Sciences Quarterly
Matthew G McCarroll, Mark S Riddle, Ramiro L Gutierrez, Chad K Porter
BACKGROUND: Previous studies have linked an increase in functional and pathological gastrointestinal (GI) disorders following antecedent infectious gastroenteritis (IGE), yet studies of other chronic GI disorders such as tropical sprue (TS) and intestinal malabsorption (IM) are lacking. This study was performed to evaluate the association between documented IGE and the risk of TS and IM using a matched case-control study. METHODS: The odds of IGE (exposure) among subjects with TS and IM were compared to the odds of exposure in matched controls...
November 2015: Digestive Diseases and Sciences
Farina M Hanif, Nasir Hassan Luck, Zaigham Abbas, Syed Mujahid Hassan, Sabhita Shabir, Muhammad Mubarak
Celiac Disease (CD), also known as non-Tropical sprue, and Celiac sprue is an immune-mediated disorder, triggered by gluten containing grains in genetically susceptible people. The disease may be diagnosed at any age and can affect many organ systems. Its diagnosis and management can often be challenging. A high index of suspicion is required to diagnose this disease at an early stage in patients presenting with atypical symptomatology and delayed onset. Although serological tests are widely used, duodenal biopsy remains the gold standard for diagnosis of CD...
April 2015: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Muhammed Ishaque, Rahma Rashid, Muhammed Mubarak
BACKGROUND: Renal transplantation is the treatment of choice for patients with end-stage renal disease. The renal transplant recipients are susceptible to a variety of gastrointestinal (GI) complications such as infections, ulcer disease, and malignancies. OBJECTIVES: We aimed to determine the frequency of pathological lesions in GI endoscopic biopsies in recipients of live related renal transplantation in our setting. METHODS: This retrospective survey was carried out at Histopathology Department of Sindh Institute of Urology and Transplantation, Karachi, from December 2010 to January 2011...
January 2015: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
Virgílio Gonçalves Pereira, Bernardo Léo Wajchenberg, Eder Rocha Quintão, Marcelo Marcondes Machado
This report describes electrolyte changes and some clinical aspects of the renal disease associated with the loss of potassium through the gastrointestinal tract in 2 patients with diarrhea. In one of them, the diarrhea resulted from non-tropical sprue, in the other, from non-beta islet-cell adenoma of pancreas. In both patients, some observations were repeated after potassium repletion.
July 1965: Metabolism: Clinical and Experimental
Joel K Greenson
Tropical sprue (TS) is a malabsorption syndrome of presumed infectious aetiology that affects residents of (or visitors to) the tropics. The histological changes of TS are similar to those of coeliac disease, with increased intraepithelial lymphocytes being central to both. Unlike in coeliac disease, however, a completely flat small bowel biopsy is uncommon in TS. TS typically involves the terminal ileum, whereas coeliac disease does not. Small intestinal bacterial overgrowth (SIBO) has been defined as an increase in number and/or a change in the type of bacteria in the upper gut...
January 2015: Histopathology
S Datta Gupta
Celiac disease is a gluten or prolamine-induced immunological disorder primarily affecting the intestines. Celiac disease is often missed since not only are clinical findings 'not typical' but also because many cases are asymptomatic. The diagnosis is based on a constellation of clinical, serological and histological findings in a duodenal biopsy, in addition to HLA genotype.and response to a gluten-free diet.Although some guidelines suggest that histology may not mandatory in every case, by and large changes in mucosal biopsies of the duodenum still remain an important diagnostic tool...
October 2013: Tropical Gastroenterology: Official Journal of the Digestive Diseases Foundation
Marijke C C Langenberg, Pieter J Wismans, Perry J J van Genderen
BACKGROUND: Within the present era of worldwide travel, it is important for all clinicians to consider the possibility of tropical sprue (TS) in returning patients with persistent diarrhoea after travel. The symptoms and histologic findings of TS can resemble but also be confused with celiac disease (CD). MATERIAL AND METHOD: Patients at our institute diagnosed with CD or TS in the period January 2000-December 2010 were eligible for inclusion. Of all patients, demographic, clinical, laboratory and endoscopy data on admission and in follow-up were collected retrospectively...
July 2014: Travel Medicine and Infectious Disease
G C Cook
In the late nineteenth and early twentieth centuries, British physicians led the way in tropical medicine research. Several years later scientific advances had slowed, and Fairley's numerous contributions were thus most welcome. Neil Hamilton Fairley was born of Scottish parents at Victoria, Australia. After qualification at Melbourne, he joined the Australian Army Medical Service (AAMS) and after several minor research projects, made valuable contributions to the understanding of tropical sprue at Bombay (now Mumbai), India...
November 2014: Journal of Medical Biography
Uday C Ghoshal, Deepakshi Srivastava, Abhai Verma, Ujjala Ghoshal
Tropical sprue (TS), once known to be a common cause of malabsorption syndrome (MAS) in India and other tropical countries, is believed to be uncommon currently in spite of contrary evidence. Several recent studies from India showed TS to be the commonest cause of sporadic MAS in Indian adults. TS is diagnosed in patients presenting with suggestive clinical presentation, which cannot be explained by another cause of MAS and investigations revealing malabsorption of two unrelated substances, abnormal small-intestinal mucosal histology, which responds to treatment with antibiotics such as tetracycline and folic acid...
2014: Current Gastroenterology Reports
Stine Astrup Hvattum, Ove B Schaffalitzky de Muckadell
A Danish woman who was on immunosuppressive medication due to a previous liver transplantation travelled to Indonesia for three weeks. After returning she developed nonfebrile severe, watery diarrhoea, dehydration and malnutrition. A thorough examination revealed small intestine changes, which were compatible with coeliac disease. However, the HLA-type and the serology did not support this diagnosis. Treatment for tropical sprue was initiated, resulting in complete remission. Tropical sprue is suggested to be an infectious disease...
January 6, 2014: Ugeskrift for Laeger
Ian S Brown, Andrew Bettington, Mark Bettington, Christophe Rosty
Tropical sprue is an acquired chronic diarrheal disorder of unclear etiology affecting residents of and visitors to tropical regions. Patients usually present with profuse diarrhea, weight loss, and malabsorption, notably of vitamin B12 and folate. The histologic changes typically resemble that of gluten-sensitive enteropathy. Reports of tropical sprue have become infrequent in the literature, and the diagnosis is often not considered either clinically or pathologically. This disease may, however, cause significant morbidity, although it is eminently treatable with broad-spectrum antibiotics...
May 2014: American Journal of Surgical Pathology
Ronald F Pfeiffer
Although malabsorption is generally considered to be a gastrointestinal problem, the effects of malabsorption extend far beyond the gastrointestinal tract and can include neurologic dysfunction. Malabsorption may occur by a variety of mechanisms, both genetic and acquired, that interfere with the absorption of basic nutrients, vitamins, minerals, and trace elements. Disorders that interfere with fat absorption can lead to neurologic dysfunction as a consequence of associated impairment of fat-soluble vitamin absorption...
2014: Handbook of Clinical Neurology
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