Tropical sprue natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Natural History, Complications and Prognosis
Natural History
Tropical sprue is a diagnosis of exclusion, patients present with chronic non-bloody diarrhea, abdominal bloating and flactulance following an episode of infectious diarrhea. Patients chronic form of tropical sprue present with features of vitamin B12 and vitamin A deficiencies such as neurological symptoms and visual disturbances. 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.
Complications
The complications of tropical sprue include:
- 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.