Tropical sprue natural history, complications and prognosis: Difference between revisions
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{{Tropical sprue}} | {{Tropical sprue}} | ||
{{CMG}}; {{AE}} | {{CMG}}; {{AE}} {{AKI}} | ||
==Overview== | ==Overview== | ||
[[Tropical sprue]] has an acute and a chronic phase and usually follows an episode of infectious [[diarrhea]]. The patients present with chronic non bloody [[diarrhea]] with [[malabsorption]]. The chronic phase can result in [[malabsorption]] and the patients will develop symptoms of [[vitamin B12]] and [[vitamin A deficiency]]. The prognosis is excellent with treatment. | |||
==Natural History, Complications and Prognosis== | ==Natural History, Complications and Prognosis== | ||
===Natural History=== | ===Natural History=== | ||
Tropical sprue is a diagnosis of exclusion, patients present with chronic non-bloody diarrhea, abdominal bloating and | [[Tropical sprue]] is a diagnosis of exclusion, patients present with chronic non-bloody [[diarrhea]], abdominal [[bloating]] and [[flatulence]] following an episode of infectious [[diarrhea]]. Patients with chronic form of [[tropical sprue]] presents with features of [[Vitamin B12 Deficiency|vitamin B12]] and [[Vitamin A deficiency|vitamin A]] deficiencies. If left untreated it is associated with significant [[morbidity]] and [[mortality]], therefore suspicion of [[tropical sprue]] must be high if histology of the duodenal [[biopsy]] demonstrates [[Villous folds|villous]] atrophy and if the patient is unresponsive to a gluten free diet.<ref name="pmid12859716">{{cite journal| author=Walker MM| title=What is tropical sprue? | journal=J Gastroenterol Hepatol | year= 2003 | volume= 18 | issue= 8 | pages= 887-90 | pmid=12859716 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12859716 }} </ref> | ||
===Complications=== | ===Complications=== | ||
The complications of tropical sprue include: | The complications of [[tropical sprue]] include:<ref name="pmid24441659">{{cite journal| author=Brown IS, Bettington A, Bettington M, Rosty C| title=Tropical sprue: revisiting an underrecognized disease. | journal=Am J Surg Pathol | year= 2014 | volume= 38 | issue= 5 | pages= 666-72 | pmid=24441659 | doi=10.1097/PAS.0000000000000153 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24441659 }} </ref> | ||
*Vitamin B12 deficiency causes sub acute combined degeneration of the spinal cord resulting in neurological symptoms. | *[[Vitamin B12]] deficiency causes sub acute combined degeneration of the [[spinal cord]] resulting in neurological symptoms. | ||
*Vitamin A deficiency causes visual disturbances and night blindness | *[[Vitamin A deficiency]] causes visual disturbances and night blindness. | ||
*Hypokalemia can occur due to chronic diarrhea | *[[Hypokalemia]] can occur due to chronic [[diarrhea]]. | ||
===Prognosis=== | ===Prognosis=== | ||
All the patients with tropical sprue have excellent prognosis with tetracycline treatment. Treatment is continued for a period of 6 months but the symptoms resolve within 2 to 3 weeks from initiation of therapy. | All the patients with [[tropical sprue]] have excellent prognosis with [[tetracycline]] treatment. Treatment is continued for a period of 6 months but the symptoms resolve within 2 to 3 weeks from initiation of therapy.<ref name="pmid5009590">{{cite journal| author=Rickles FR, Klipstein FA, Tomasini J, Corcino JJ, Maldonado N| title=Long-term follow-up of antibiotic-treated tropical sprue. | journal=Ann Intern Med | year= 1972 | volume= 76 | issue= 2 | pages= 203-10 | pmid=5009590 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=5009590 }} </ref> | ||
==References== | ==References== | ||
Latest revision as of 18:39, 22 December 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aravind Kuchkuntla, M.B.B.S[2]
Overview
Tropical sprue has an acute and a chronic phase and usually follows an episode of infectious diarrhea. The patients present with chronic non bloody diarrhea with malabsorption. The chronic phase can result in malabsorption and the patients will develop symptoms of vitamin B12 and vitamin A deficiency. The prognosis is excellent with treatment.
Natural History, Complications and Prognosis
Natural History
Tropical sprue is a diagnosis of exclusion, patients present with chronic non-bloody diarrhea, abdominal bloating and flatulence following an episode of infectious diarrhea. Patients with chronic form of tropical sprue presents with features of vitamin B12 and vitamin A deficiencies. If left untreated it is associated with significant morbidity and mortality, therefore suspicion of tropical sprue must be high if histology of the duodenal biopsy demonstrates villous atrophy and if the patient is unresponsive to a gluten free diet.[1]
Complications
The complications of tropical sprue include:[2]
- Vitamin B12 deficiency causes sub acute combined degeneration of the spinal cord resulting in neurological symptoms.
- Vitamin A deficiency causes visual disturbances and night blindness.
- Hypokalemia can occur due to chronic diarrhea.
Prognosis
All the patients with tropical sprue have excellent prognosis with tetracycline treatment. Treatment is continued for a period of 6 months but the symptoms resolve within 2 to 3 weeks from initiation of therapy.[3]
References
- ↑ Walker MM (2003). "What is tropical sprue?". J Gastroenterol Hepatol. 18 (8): 887–90. PMID 12859716.
- ↑ Brown IS, Bettington A, Bettington M, Rosty C (2014). "Tropical sprue: revisiting an underrecognized disease". Am J Surg Pathol. 38 (5): 666–72. doi:10.1097/PAS.0000000000000153. PMID 24441659.
- ↑ Rickles FR, Klipstein FA, Tomasini J, Corcino JJ, Maldonado N (1972). "Long-term follow-up of antibiotic-treated tropical sprue". Ann Intern Med. 76 (2): 203–10. PMID 5009590.