nontropical sprue


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sprue

 [sproo]
a chronic form of malabsorption syndrome occurring in both tropical and nontropical forms.
celiac sprue (nontropical sprue) celiac disease.
tropical sprue a chronic disease affecting the digestive system, marked by imperfect absorption of food elements, especially fat, xylose, and vitamin B12, from the small intestine. It is closely related to celiac disease and may be identical to it.



The name sprue derives from a Dutch word describing inflammation of the mouth, which is a frequent symptom. The disease has been recognized for more than 2000 years. It occurs mostly, but not exclusively, in the tropics.
Symptoms and Treatment. Symptoms are loss of appetite, flatulence, anemia, diarrhea, stomach cramps, and extreme loss of weight. Stools are usually pale, greasy, unformed, and foul-smelling, but at times become watery. If a deficiency of vitamin B complex is also present, cracks develop at the corners of the mouth and the tongue becomes smooth, glossy, and bright red.



Treatment consists of a special diet of foods that are low in fat and high in protein. Diets free of gluten, a viscid grain protein, may be prescribed. Liver preparations, folic acid, calcium lactate tablets, vitamin B12, and iron supplements to provide food elements that are not absorbed, as well as skim milk and ripe bananas, have produced favorable results. Antibiotics have proved temporarily successful, but their prolonged use is not recommended.

Cases of sprue that are recognized early respond better to treatment than do cases of long standing. Appetite and weight return rapidly. The time required for complete recovery is prolonged, however, especially in extreme cases.

nontropical sprue

(nŏn′trŏp′ĭ-kəl)

nontropical sprue

[-trop′ikəl]
Etymology: L, non, not; Gk, tropikos, of the solstice; D, sprouw
a malabsorption syndrome resulting from an inborn inability to digest foods that contain gluten. See also celiac disease, tropical sprue.

coeliac disease

A malabsorptive syndrome caused by hypersensitivity of intestinal mucosa to alpha-gliadin, a gluten extract composed of glutamine and proline-rich proteins that is found in wheat, barley, rye, and oats.
 
Clinical findings
Diarrhoea, copious fatty stools, abdominal distension, weight loss, haemorrhage, osteopenia, muscle atrophy, peripheral neuropathy, CNS and spinal cord demyelination (sensory loss, ataxia), amenorrhoea, infertility, oedema, petechiae, dermatitis herpetiformis (especially if HLA B27), alopecia areata. Occult bleeding occurs in half of patients.
 
Lab
Transaminases (ALT, AST) are increased in ± 40% of patients with CD, which usually normalises with a gluten-free diet; iron deficiency, anaemia due to occult bleeding.

Diagnosis
Duodenal biopsy; anti-gliadin and anti-endomysial antibodies.
 
Management
Eliminate gliadin from diet.

Prognosis
Without treatment, 10–15% develop lymphoma (e.g., immunoblastic lymphoma; less commonly, T cell lymphoma), a risk that increases with disease duration. CD predisposes to gastrointestinal lymphoma and carcinoma of the oral cavity and oesophagus; the otherwise rare small intestinal adenocarcinoma is 80-fold more common in CD.

nontropical sprue

Gluten enteropathy, see there aka celiac sprue.

non·trop·i·cal sprue

(non-trop'ik-ăl sprū)
Sprue occurring in persons away from the tropics; usually called celiac disease; due to gluten-induced enteropathy.

nontropical sprue

see sprue.

Patient discussion about nontropical sprue

Q. Is celiac genetic? I have one son with celiac disease from my first marriage and me second wife is now pregnant,I was wondering what are the chances for this soon to be born daughter of mine to have celiac as well- if I maybe carry the genetic flaw and is there a way to find out?

A. Celiac disease is a very common illness (about 1 in a 100 people suffer from it in different levels), and it is known to have a strong genetic connection. However, there is not one specific mutation that you can get genetic testing to see if you are carrying it. Your soon to be born daughter will have a higher chance than the regular population to suffer from the disease, but it does not necessarily mean she will.

Q. How do you diagnose celiac? My daughter is 3 years old and is constantly vomiting, has diarrhea and stomach aches. Could this be celiac?

A. This could in fact be celiac. The initial step in screening should include: IgA endomysial antibodies (EMA), IgA tissue transglutaminase (tTG), IgG tissue transglutaminase and Total IgA antibodies. The patients with positive antibody tests, and those with an IgA deficiency, should have a small bowel biopsy to confirm the diagnosis and assess the degree of damage, which is performed endoscopically (looking inside the body by inserting a tube into it).

Q. Is FTT a symptom of celiac? My 1.5 year old son has FTT (failure to thrive) and stomach aches. What could be causing it?

A. Failure to thrive lacks a precise definition, in part because it describes a condition rather than a specific disease. Children who fail to thrive don't receive or are unable to take in, retain, or utilize the calories needed to gain weight and grow as expected. FTT can be caused from many different things: social factors, conditions involving the gastrointestinal system like gastroesophageal reflux, chronic diarrhea, cystic fibrosis, chronic liver disease, and celiac disease. From a chronic illness or medical disorder, an intolerance of milk protein, infections or metabolic disorders.

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