Tropical sprue pathophysiology: Difference between revisions

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==Pathophysiology==
==Pathophysiology==
'''Infection'''
* Accompanied by Fever at the onset of the disease
* Increase in the gram-negative bacterial toxins and bacterial colony counts
* Precipitated by a history of acute gastroenteritis.<ref name="pmid26115751">{{cite journal| author=McCarroll MG, Riddle MS, Gutierrez RL, Porter CK| title=Infectious Gastroenteritis as a Risk Factor for Tropical Sprue and Malabsorption: A Case-Control Study. | journal=Dig Dis Sci | year= 2015 | volume= 60 | issue= 11 | pages= 3379-85 | pmid=26115751 | doi=10.1007/s10620-015-3768-8 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26115751  }} </ref>
* There is an increase in the inflammatory cells in the lamina propria with variable edema
* Good clinical response to Tetracycline with restoration of the normal histology.
Bacterial overgrowth leading to toxin production.<ref name="Walker2003">{{cite journal|last1=Walker|first1=Marjorie M|title=What is tropical sprue?|journal=Journal of Gastroenterology and Hepatology|volume=18|issue=8|year=2003|pages=887–890|issn=0815-9319|doi=10.1046/j.1440-1746.2003.03127.x}}</ref>
Bacterial overgrowth leading to toxin production.<ref name="Walker2003">{{cite journal|last1=Walker|first1=Marjorie M|title=What is tropical sprue?|journal=Journal of Gastroenterology and Hepatology|volume=18|issue=8|year=2003|pages=887–890|issn=0815-9319|doi=10.1046/j.1440-1746.2003.03127.x}}</ref>



Revision as of 13:55, 17 February 2017

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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

Pathophysiology

Infection

  • Accompanied by Fever at the onset of the disease
  • Increase in the gram-negative bacterial toxins and bacterial colony counts
  • Precipitated by a history of acute gastroenteritis.[1]
  • There is an increase in the inflammatory cells in the lamina propria with variable edema
  • Good clinical response to Tetracycline with restoration of the normal histology.

Bacterial overgrowth leading to toxin production.[2]

Histology

The histological changes of TS include: Flattening of the villi and small intestinal inflammation which are similar to an autoimmune disorder Coeliac disease (also known as coeliac sprue).

Diagnosis Villous morphology Findings in Lamina propria Involved portion of the GI tract
Tropical sprue Mild to moderate blunting of the villi with an increased number of Intraepithelial lymphocytes. Increased number of plasma cells and eosinophils. Ileum > Duodenum > Colon
Celiac sprue Variable, often there is a complete flattening of the villi. Always there is an increased number of Intraepithelial lymphocytes Plasma cells > Eosinophils > Neutrophils. Duodenum > Ileum.

References

  1. McCarroll MG, Riddle MS, Gutierrez RL, Porter CK (2015). "Infectious Gastroenteritis as a Risk Factor for Tropical Sprue and Malabsorption: A Case-Control Study". Dig Dis Sci. 60 (11): 3379–85. doi:10.1007/s10620-015-3768-8. PMID 26115751.
  2. Walker, Marjorie M (2003). "What is tropical sprue?". Journal of Gastroenterology and Hepatology. 18 (8): 887–890. doi:10.1046/j.1440-1746.2003.03127.x. ISSN 0815-9319.

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