Tropical sprue laboratory findings: Difference between revisions
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{{familytree | | | | | | | | | | | | | | | A01 | A01= Clinical suspicion of malabsorption syndrome}} | {{familytree | | | | | | | | | | | | | | | A01 | A01= Clinical suspicion of malabsorption syndrome}} | ||
{{familytree | | | | | | | | | | | | | | | |!| | }} | {{familytree | | | | | | | | | | | | | | | |!| | }} | ||
{{familytree | | | | | | | | | | | | | | | B01 | |B01= Initial screening perform: <br> Stool Microscopy to rule out infectious causes <br> D-xylose test to test for the presence of intestinal enterocyte dysfunction <br> Fecal fat test for detection of steatorrhea}} | {{familytree boxstyle=text-align: left; | | | | | | | | | | | | | | | B01 | |B01= Initial screening perform: <br>* Stool Microscopy to rule out infectious causes <br>* D-xylose test to test for the presence of intestinal enterocyte dysfunction <br>* Fecal fat test for detection of steatorrhea}} | ||
{{familytree | | | | | | | | | | | | | | | |!| |}} | {{familytree | | | | | | | | | | | | | | | |!| |}} | ||
{{familytree | | | | | | | | | | | | | | | C01 | | | | | | | | C01=Confirmatory tests for malabsoption should be done}} | {{familytree | | | | | | | | | | | | | | | C01 | | | | | | | | C01=Confirmatory tests for malabsoption should be done}} | ||
{{familytree | | | | | | | | | | | | | | | |!| |}} | {{familytree | | | | | | | | | | | | | | | |!| |}} | ||
{{familytree | | | | | | | | | | | | | | | D01 | |D01= Positive antiendomysial antibodies and villous atrophy suggests celiac disease <br> Positive breath hydrogen test suggests lactase deficiency <br> Positive microscopy and culture of jejunal aspirate suggests small bowel bacterial overgrowth <br> Low serum immunoglobulin suggests B-cell deficiency <br> HIV serology <br> CT enterography to rule out intestinal inflammatory conditions <br> Abdomen CT to rule out chronic pancreatitis}} | {{familytree boxstyle=text-align: left; | | | | | | | | | | | | | | | D01 | |D01= *Positive antiendomysial antibodies and villous atrophy suggests celiac disease <br>* Positive breath hydrogen test suggests lactase deficiency <br> *Positive microscopy and culture of jejunal aspirate suggests small bowel bacterial overgrowth <br>* Low serum immunoglobulin suggests B-cell deficiency <br>* HIV serology <br> *CT enterography to rule out intestinal inflammatory conditions <br>* Abdomen CT to rule out chronic pancreatitis}} | ||
{{familytree | | | | | | | | | | | | | | | |!| |}} | {{familytree | | | | | | | | | | | | | | | |!| |}} | ||
{{familytree | | | | | | | | | | | | | | | E01 | | E01= Once other possibilities are ruled out, suspect diagnosis of tropical sprue}} | {{familytree | | | | | | | | | | | | | | | E01 | | E01= Once other possibilities are ruled out, suspect diagnosis of tropical sprue}} |
Revision as of 16:19, 13 April 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Laboratory Findings
Tropical sprue is diagnosed based on the following criteria:[1]
- Clinical presentation with chronic non bloody diarrhea with malabsorption
- Presence of malabsorption for two different substances
- Abnormal small intestinal histological findings
- Exclusion of other causes of malabsorption
- Response to treatment with tetracycline and folic acid
All the patients with celiac disease unresponsive to gluten free diet, a diagnosis of tropical sprue must be considered. The lab findings are not specific for tropical sprue as it is a diagnosis of exlclusion. [2]
- Patients with ileal involvement will have low vitamin B12 and folate levels.[3]
- Normal transglutaminase, immunoglobulin levels are present.
- Peripheral blood smear will demonstrate megaloblastic picture.
Approach to a Patient With Malabsorption in Tropical Region
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Clinical suspicion of malabsorption syndrome | |||||||||||||||||||||||||||||||||||||||||||||||
Confirmatory tests for malabsoption should be done | |||||||||||||||||||||||||||||||||||||||||||||||
Once other possibilities are ruled out, suspect diagnosis of tropical sprue | |||||||||||||||||||||||||||||||||||||||||||||||
Start tetracycline therapy Improvement of symptoms with tetracycline confirms the diagnosis | |||||||||||||||||||||||||||||||||||||||||||||||
References
- ↑ Walker MM (2003). "What is tropical sprue?". J Gastroenterol Hepatol. 18 (8): 887–90. PMID 12859716.
- ↑ Bonnefoy S, Chauvin A, Galéano-Cassaz C, Camilleri-Broet S, Jacquet SF, Carmoi T; et al. (2012). "[Tropical sprue in an expatriate]". Rev Med Interne. 33 (5): 284–7. doi:10.1016/j.revmed.2012.01.015. PMID 22405324.
- ↑ Misra RC, Kasthuri D, Chuttani HK (1967). "Correlation of clinical, biochemical, radiological, and histological findings in tropical sprue". J Trop Med Hyg. 70 (1): 6–10. PMID 6016817.