Tropical sprue differential diagnosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Tropical sprue must be differentiated from celiac disease, chronic diarrhea, Clonorchiasis, traveler's diarrhea, and whipworm.
Differentiating Tropical sprue from other Diseases
| Causes | Pathophysiology and Histology | Fever | Vomiting | Acute diarrhea | Traveller's diarrhea | Chronic diarrhea | Malabsorption | Steatorrhoea | Diagnosis | Confirmatory tests | Associations | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Tropical sprue | ||||||||||||
| Tropical Enteropathy | Increased mucosal permeability, shorter villi, elongated crypts and increased lymphocytes in the lamina propria | Subclinical | ||||||||||
| Infectious | Protozoal |
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| Helminths | ||||||||||||
| Bacterial | ||||||||||||
| Viral | ||||||||||||
| Inflammatory and Immune mediated | Crohn's disease | Decreased small intestinal absorptive surface area | ||||||||||
| Ulcerative colitis | ||||||||||||
| Coeliac sprue | Complete villous atrophy of the jejunal mucosa | Antiendomysial and tissue transglutaminase antibodies | Clinical and histological response to gluten withdrawal. | |||||||||
| Malignant | Intestinal Lymphoma | |||||||||||
| Pancreatic disease | ||||||||||||
| Post Infective-Irritable bowel syndrome.[1] | Following acute gastroenteritis, genetic susceptibility, change in gut flora, altered small intestinal permeability and sensory motor function | ✔ | ✔ | ✔ | Positive stool culture | |||||||
Chronic diarrhea
- Tropical sprue
- Ulcerative Colitis,
- Crohn's disease
- Diarrhea, chronic responsive to antiparasitic drugs
- Diarrhea, chronic unknown
- Inflammatory bowel disease, new onset post-travel (Crohn or ulcerative colitis)
- Irritable bowel syndrome
- Irritable bowel syndrome, post infectious
- Lactose intolerance, post infectious
- Malabsorption
Acute diarrhea
- E. coli
- Clostridium difficile-associated disease
- Campylobacter
- Cholera (toxigenic Vibrio cholerae)
- Cryptosporidium
- Cyclospora
- Diarrhea, acute bacterial
- Diarrhea, acute parasitic
- Diarrhea, acute unspecified
- Diarrhea, acute viral
- Dysentery, acute unspecified
- Entamoeba histolytica, ameba
- E. histolytica, diarrhea
- E. histolytica, dysentery
- Food poisoning
- Gastroenteritis
- Giardia
- Isospora
- Noncholera Vibrio
- Salmonella, other
- Shiga toxin-producing Escherichia coli
- Shigella, S. boydii
- Shigella, S. dysenteriae
- Shigella, S. flexneri
The following diseases have a similar presentation to tropical sprue.
- Celiac Disease
- Chronic diarrhea
- Clonorchiasis
- Traveler's diarrhea
- Whipworm
References
- ↑ Ghoshal, Uday C; Ranjan, Prabhat (2011). "Post-infectious irritable bowel syndrome: The past, the present and the future". Journal of Gastroenterology and Hepatology. 26: 94–101. doi:10.1111/j.1440-1746.2011.06643.x. ISSN 0815-9319.