Tropical sprue differential diagnosis: Difference between revisions

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! colspan="2" style="background: #4479BA; text-align: center;" | {{fontcolor|#FFF|Causes}}
! colspan="2" style="background: #4479BA; text-align: center;" | {{fontcolor|#FFF|Causes}}
!colspan="1" style="background: #4479BA; text-align: center;" | {{fontcolor|#FFF|Pathophysiology and Histology}}
!colspan="1" style="background: #4479BA; text-align: center;" | {{fontcolor|#FFF|Pathophysiology and Histology}}
!Fever
!Vomiting
!colspan="1" style="background: #4479BA; text-align: center;" | {{fontcolor|#FFF|Acute diarrhea}}
!colspan="1" style="background: #4479BA; text-align: center;" | {{fontcolor|#FFF|Acute diarrhea}}
!colspan="1" style="background: #4479BA; text-align: center;" | {{fontcolor|#FFF|Traveller's diarrhea}}
!colspan="1" style="background: #4479BA; text-align: center;" | {{fontcolor|#FFF|Traveller's diarrhea}}
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! colspan="2" |Tropical sprue
! colspan="2" |Tropical sprue
!
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! colspan="2" |Tropical Enteropathy
! colspan="2" |Tropical Enteropathy
!Increased mucosal permeability, shorter villi, elongated crypts and increased lymphocytes in the lamina propria
!Increased mucosal permeability, shorter villi, elongated crypts and increased lymphocytes in the lamina propria
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!
!
!
!
!
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*  
*  
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!Helminths
!Helminths
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!
!
!
!
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!Bacterial
!Bacterial
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!
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!Viral
!Viral
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!Crohn's disease
!Crohn's disease
!Decreased small intestinal absorptive surface area
!Decreased small intestinal absorptive surface area
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!
!
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!Ulcerative colitis
!Ulcerative colitis
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!
!
!
!
!
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!Coeliac sprue
!Coeliac sprue
!Complete villous atrophy of the jejunal mucosa
!Complete villous atrophy of the jejunal mucosa
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!
!
!
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!Malignant
!Malignant
!Intestinal Lymphoma
!Intestinal Lymphoma
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!
!
!
!
!
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! colspan="2" |Pancreatic disease
! colspan="2" |Pancreatic disease
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! colspan="2" |Irritable bowel syndrome.<ref name="GhoshalRanjan2011">{{cite journal|last1=Ghoshal|first1=Uday C|last2=Ranjan|first2=Prabhat|title=Post-infectious irritable bowel syndrome: The past, the present and the future|journal=Journal of Gastroenterology and Hepatology|volume=26|year=2011|pages=94–101|issn=08159319|doi=10.1111/j.1440-1746.2011.06643.x}}</ref>
! colspan="2" |Post Infective-Irritable bowel syndrome.<ref name="GhoshalRanjan2011">{{cite journal|last1=Ghoshal|first1=Uday C|last2=Ranjan|first2=Prabhat|title=Post-infectious irritable bowel syndrome: The past, the present and the future|journal=Journal of Gastroenterology and Hepatology|volume=26|year=2011|pages=94–101|issn=08159319|doi=10.1111/j.1440-1746.2011.06643.x}}</ref>


!Following acute gastroenteritis, genetic susceptibility, change in gut flora, altered small intestinal permeability and sensory motor function
!✔
!✔
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|✔
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|Positive stool culture
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Revision as of 15:22, 22 February 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Tropical sprue must be differentiated from celiac disease, chronic diarrhea, Clonorchiasis, traveler's diarrhea, and whipworm.

Differentiating Tropical sprue from other Diseases

Differentiating Tropical sprue from other causes of Tropical malabsorption
Causes Pathophysiology and Histology Fever Vomiting Acute diarrhea Traveller's diarrhea Chronic diarrhea Malabsorption Steatorrhoea Diagnosis Confirmatory tests Associations
Tropical sprue
Tropical Enteropathy Increased mucosal permeability, shorter villi, elongated crypts and increased lymphocytes in the lamina propria Subclinical
Infectious Protozoal
Helminths
Bacterial
Viral
Inflammatory and Immune mediated Crohn's disease Decreased small intestinal absorptive surface area
Ulcerative colitis
Coeliac sprue Complete villous atrophy of the jejunal mucosa Antiendomysial and tissue transglutaminase antibodies Clinical and histological response to gluten withdrawal.
Malignant Intestinal Lymphoma
Pancreatic disease
Post Infective-Irritable bowel syndrome.[1] Following acute gastroenteritis, genetic susceptibility, change in gut flora, altered small intestinal permeability and sensory motor function ✔ ✔ ✔ Positive stool culture

Chronic diarrhea

  • Tropical sprue
  • Ulcerative Colitis,
  • Crohn's disease
  • Diarrhea, chronic responsive to antiparasitic drugs
  • Diarrhea, chronic unknown
  • Inflammatory bowel disease, new onset post-travel (Crohn or ulcerative colitis)
  • Irritable bowel syndrome
  • Irritable bowel syndrome, post infectious
  • Lactose intolerance, post infectious
  • Malabsorption

Acute diarrhea

  • E. coli
  • Clostridium difficile-associated disease
  • Campylobacter
  • Cholera (toxigenic Vibrio cholerae)
  • Cryptosporidium
  • Cyclospora
  • Diarrhea, acute bacterial
  • Diarrhea, acute parasitic
  • Diarrhea, acute unspecified
  • Diarrhea, acute viral
  • Dysentery, acute unspecified
  • Entamoeba histolytica, ameba
  • E. histolytica, diarrhea
  • E. histolytica, dysentery
  • Food poisoning
  • Gastroenteritis
  • Giardia
  • Isospora
  • Noncholera Vibrio
  • Salmonella, other
  • Shiga toxin-producing Escherichia coli
  • Shigella, S. boydii
  • Shigella, S. dysenteriae
  • Shigella, S. flexneri

The following diseases have a similar presentation to tropical sprue.

References

  1. ↑ Ghoshal, Uday C; Ranjan, Prabhat (2011). "Post-infectious irritable bowel syndrome: The past, the present and the future". Journal of Gastroenterology and Hepatology. 26: 94–101. doi:10.1111/j.1440-1746.2011.06643.x. ISSN 0815-9319.

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