Tropical sprue natural history, complications and prognosis: Difference between revisions
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==Prognosis== | ==Prognosis== | ||
The prognosis for tropical sprue is excellent. It usually does not recur in patients who get it during travel to affected regions. The recurrence rate for natives is about 20%. | The prognosis for tropical sprue is excellent. It usually does not recur in patients who get it during travel to affected regions. The recurrence rate for natives is about 20%. In epidemics, the recovery of TS after treatment with antibiotics, B12 and folate replacement is usually rapid and dramatic.<ref name="BathejaLeighton2010">{{cite journal|last1=Batheja|first1=Mashal Jatoi|last2=Leighton|first2=Jonathan|last3=Azueta|first3=Ainara|last4=Heigh|first4=Russell|title=The Face of Tropical Sprue in 2010|journal=Case Reports in Gastroenterology|volume=4|issue=2|year=2010|pages=168–172|issn=1662-0631|doi=10.1159/000314231}}</ref> | ||
==References== | ==References== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
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Overview
Natural History
- The clinical presentation depends on the duration of illness.
- Some patients may have symptoms lasting for days to weeks while other have a chronic course with remissions and relapses for many years.
- Malabsorption, may be seen as early as week after the onset of symptoms but manifestations of specific vitamin deficiencies may take longer.
- With no treatment, mortality in an epidemic reaches 30%.[1]
- During the early stages of the illness, the mortality is mainly related to the fluid and electrolyte imbalances.
- Later in the disease deaths are associated with anemia, hypoproteinemia and secondary infection.
- Among the patients who survive, there is a strong tendency to spontaneous recovery even without treatment.
Complications
Vitamin and mineral deficiencies are common complications due to continued fluid and electrolyte losses associated with diarrhea.
- Dehydration
- Hyponatremia
- Hypokalemia
- Hypomagnesemia
- Metabolic acidosis
In children, sprue leads to:
- Delay in the maturing of bones (skeletal maturation)
- Growth
Prognosis
The prognosis for tropical sprue is excellent. It usually does not recur in patients who get it during travel to affected regions. The recurrence rate for natives is about 20%. In epidemics, the recovery of TS after treatment with antibiotics, B12 and folate replacement is usually rapid and dramatic.[2]
References
- ↑ Baker SJ, Mathan VI (1968). "Syndrome of tropical sprue in South India". Am J Clin Nutr. 21 (9): 984–93. PMID 5675861.
- ↑ Batheja, Mashal Jatoi; Leighton, Jonathan; Azueta, Ainara; Heigh, Russell (2010). "The Face of Tropical Sprue in 2010". Case Reports in Gastroenterology. 4 (2): 168–172. doi:10.1159/000314231. ISSN 1662-0631.