Tropical Sprue

Klipstein, Frederick A.

doi:10.1016/s0016-5085(68)80016-2

Cited by 54 publications

(11 citation statements)

References 119 publications

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“…Systemic infection might have been a contributory factor in the depression of xylose absorption, but it seems extremely unlikely that it was entirely responsible. The patients in the present investigation did not have tropical sprue (Klipstein, 1968;Baker, 1972;Cook, 1974a). The clinical presentation and absence of severe morphological changes in the jejunum, in those in whom it was studied, are inconsistent with that diagnosis.…”

Section: Discussionmentioning

confidence: 52%

Absorption of xylose, glucose, glycine, and folic (pteroylglutamic) acid in Zambian Africans with anaemia.

Cook¹

1976

Gut

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SUMMARY Rates of glucose, glycine, and folic (pteroylglutamic) acid absorption were determined for a 30 cm jejunal segment in vivo, with a double-lumen tube perfusion system, in 10 Zambian African women with a mean haemoglobin concentration of 5d1 (3.5-9.2) g/dl. In four the anaemia was megaloblastic (due to folate deficiency) and in six hypochromic. Perfusion solutions contained (1) glucose 200 mmol/l, (2) glycine 100 mmol/l, and (3) folic acid 250 ,ug/l. D-xylose absorption after a 25 g oral load was determined in them, and also in 18 additional patients (11 had megaloblastic and seven either hypochromic or haemolytic anaemia). Xylose absorption tests were significantly impaired in the patients with megaloblastic compared with hypochromic or haemolytic anaemia (p < 0.001); those with untreated megaloblastic anaemia had a greater abnormality than those who had started treatment. Mean glucose, glycine, and folic acid absorption rates were similar to those in controls, and the rates in patients with megaloblastic and hypochromic anaemia were not significantly different. Correlation between glucose absorption rate and xylose excretion was, however, significant (p < 0 02). If more patients had been studied it seems likely therefore that a significant impairment of glucose absorption rate in the presence of megaloblastic anaemia would also have been demonstrated. In this investigation anaemia per se did not affect glucose, glycine, or folic acid absorption rates or xylose absorption, but xylose absorption was reduced in patients with megaloblastic anaemia. That abnormality was probably related to folate deficiency, and the underlying mechanism seems to be different from that causing impairment of monosaccharide absorption in patients with systemic bacterial infections. Mean glycine and folic acid absorption rates were not altered by megaloblastic anaemia, indicating that folate deficiency does not cause a general depression of absorption.

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Section: Discussionmentioning

confidence: 52%

Absorption of xylose, glucose, glycine, and folic (pteroylglutamic) acid in Zambian Africans with anaemia.

Cook¹

1976

Gut

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“…From our unit Wicks and Clain (1975) recorded a mean of 9 5 g for faecal fat excretion in a group with pancreatic steatorrhoea, which is higher than the mean of 5 4 g in our tropical sprue. Steatorrhoea is often absent in tropical sprue (Jeejeebhoy et al, 1968;Cowan et al, 1968;Gardner, 1956;Klipstein, 1968) and the design of the Ugandan study was biased towards gross steatorrhoea and pancreatic disease. It is therefore possible that other cases of tropical sprue were missed.…”

Section: Discussionmentioning

confidence: 99%

“…Authorities on the disease and experienced workers in various parts of Africa (Trowell, 1960;Banwell et al, 1967;Klipstein, 1968;Baker and Mathan, 1970;Foy and Kondi, 1971;Cook, 1974) have agreed that tropical sprue occurs extremely rarely, if at all, despite the presence of subclinical enteropathy.…”

mentioning

confidence: 99%

Endemic tropical sprue in Rhodesia.

Thomas¹,

Clain²

1976

Gut

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SUMMARY The existence of tropical sprue in Africa is controversial. In this paper we present 31 cases seen in Rhodesia over a 15 month period. They have the clinical features, small intestinal morphology, malabsorption pattern, and treatment response of tropical sprue. Other causes of malabsorption, and primary malnutrition, have been excluded. The severity of the clinical state and intestinal malabsorption distinguish these patients from those we have described with tropical enteropathy. The previous work on tropical sprue in Africa is reviewed and it is apparent that, when it has been adequately looked for, it has been found. It is clear that the question of tropical sprue in Africa must be re-examined and that its existence may have hitherto been concealed by the assumption that primary malnutrition is responsible for the high prevalence of deficiency states.

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“…Elle a été constatée tout d'abord chez les Européens et les Américains vivant en zone tropicale, puis vers 1950 chez les autochtones d'Inde [2,3]. Puis elle a été remarquée aux Antilles, en Inde et en Asie du Sud-Est [4]. Le mot sprue vient d'un mot hollandais "sprow" (aphte), qui a été transformé en "sprue" par Manson en 1880.…”

Section: ■ Points Essentielsunclassified

“…Cette affection a été comparée au syndrome de l'anse stagnante, mais il s'agit dans ce cas d'une flore anaérobie avec des coliformes ne produisant pas de toxine [7]. Certains facteurs favorisants ont pu être constatés : carence protéinocalorique [16], colonisation bactérienne chronique du grêle, consommation d'acides gras insaturés [13], hypochlorhydrie gastrique [4], ralentissement du transit. Cependant, il existe aussi des arguments contre ces conclusions : les coliformes ne sont pas trouvés chez tous les patients et cette pullulation, qui réagit de façon variable aux antibiotiques, n'est pas proportionnelle à la gravité de la maladie [16].…”

Section: Physiopathologie : Mal Expliquéeunclassified

Sprue tropicale

Bourée¹

2007

La Presse Médicale

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Tropical Sprue

Cited by 54 publications

References 119 publications

Absorption of xylose, glucose, glycine, and folic (pteroylglutamic) acid in Zambian Africans with anaemia.

Absorption of xylose, glucose, glycine, and folic (pteroylglutamic) acid in Zambian Africans with anaemia.

Endemic tropical sprue in Rhodesia.

Sprue tropicale

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