Tropical sprue natural history, complications and prognosis: Difference between revisions

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==Natural History==
==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%.<ref name="pmid5675861">{{cite journal| author=Baker SJ, Mathan VI| title=Syndrome of tropical sprue in South India. | journal=Am J Clin Nutr | year= 1968 | volume= 21 | issue= 9 | pages= 984-93 | pmid=5675861 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=5675861  }} </ref>
* 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==
==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==
==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%.


==References==
==References==

Revision as of 15:00, 23 February 2017

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