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    Tropical Sprue-wps Office

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    kitymans
    Tropical sprue is a chronic malabsorption condition prevalent in tropical regions, particularly India, characterized by gastrointestinal infections leading to structural damage in the small intestine. Clinical features include diarrhea, weight loss, and nutritional deficiencies, with diagnosis often requiring endoscopy and biopsy. Management primarily involves antibiotics and vitamin supplementation, distinguishing it from celiac sprue based on etiology and clinical presentation.

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    Tropical Sprue-wps Office

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    kitymans
    3 views15 pages
    Tropical sprue is a chronic malabsorption condition prevalent in tropical regions, particularly India, characterized by gastrointestinal infections leading to structural damage in the small intestine. Clinical features include diarrhea, weight loss, and nutritional deficiencies, with diagnosis often requiring endoscopy and biopsy. Management primarily involves antibiotics and vitamin supplementation, distinguishing it from celiac sprue based on etiology and clinical presentation.

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    Tropical sprue is a chronic malabsorption condition prevalent in tropical regions, particularly India, characterized by gastrointestinal infections leading to structural damage in the small intestine. Clinical features include diarrhea, weight loss, and nutritional deficiencies, with diagnosis often requiring endoscopy and biopsy. Management primarily involves antibiotics and vitamin supplementation, distinguishing it from celiac sprue based on etiology and clinical presentation.

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    © All Rights Reserved
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    Download as pptx, pdf, or txt
    3 views15 pages

    Tropical Sprue-wps Office

    Uploaded by

    kitymans
    Tropical sprue is a chronic malabsorption condition prevalent in tropical regions, particularly India, characterized by gastrointestinal infections leading to structural damage in the small intestine. Clinical features include diarrhea, weight loss, and nutritional deficiencies, with diagnosis often requiring endoscopy and biopsy. Management primarily involves antibiotics and vitamin supplementation, distinguishing it from celiac sprue based on etiology and clinical presentation.

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    TROPICAL SPRUE

    SYNOPSIS
    • Introduction
    • Pathogenesis
    • Clinical features
    • Investigations
    • Management
    • Differential diagnosis
    • Difference between Celiac sprue and tropical sprue
    INTRODUCTION
    • Chronic progressive malabsorption in a patient in or
    from a tropical country , associated with
    abnormalities of small intestinal structure and
    function .

    • Celiac sprue is most common malabsorption


    diasese in worldwide

    • Tropical sprue is common in India


    PATHOGENESIS
    • In India any osmotic diarrhoea suspect tropical
    sprue
    • Gastrointestinal infection is the precipitating factor
    • Small intestine bacterial overgrowth (Escherichia
    coli, Enterobacter,klebsiella)
    • Produce toxins - damages mucosal epithelial cells
    ( structural damage distal more than proximal )
    leads to malabsorption.
    CLINICAL FEATURES

    • Diarrhoea and abdominal distension( carbohydrate


    malabsorption )
    • Pale and bulky stools ( fat malabsorption )
    • Foul smelling stools ( protein malabsorption )
    • Anorexia
    • Weight loss
    • Fatigue

    • In visitors of tropics the onset of severe diarrhoea


    maybe sudden and accompanied by fever
    Hyperpigmentation of
    palms – megaloblastic
    anaemia
    Clinical features
    • In chronic the features include
    • Megaloblastic anaemia (vitamin B12 and folic acid
    mal absorption )and other deficiencies
    • Ankle edema ( protein loss enteropathy)
    • Glossitis and stomatitis ( vitamin B deficiency)
    • Night blindness (vitamin A deficiency )
    • Muscle weakness ( hypokalemia hypomagnecemia )
    • Tetany and carpopedal spasm
    Investigations

    • Small intestine endoscopy and biopsy - non


    specific , indistinguishable from celiac disease
    • Villous atrophy ,crypt hyperplasia, mononuckear
    infiltrates in lamina propia, increased IELS
    • Low levels of folic acid , vitamin B12,A,D,E,K,
    albumin , calcium.
    • Examination of stools - steatorrhea
    • Barium swallow - thickening of bowel loops
    Biopsy of small intestine-
    tropical sprue
    Management
    • Tetracycline ( 250 mg four times daily for 28 days ) -
    treatment of choice
    • Folic acid ( 5 mg daily ) improves symptoms and
    jejunal morphology.
    Differential diagnosis
    • Celiac sprue
    • Giardiasis ( examination of stools - cysts and
    tropozoites )
    Celiac sprue Tropical sprue

    Geography Europe and North Indian sub-continent,


    america west africa, caribbean

    Etiology Autoimmune Unknown probably


    mediiated infectious, travel
    history.
    Family history Yes No
    HLA- DQ2,8

    Clinical features Fe deficiency anemia Megaloblastic anemia


    common and folate deficiency
    common
    Distribution Proximal Proximal and distal

    Serology ELISA for tissue None


    transglutaminase

    Management Gluten free diet Antibiotics, vitamin


    B12 and folate
    supplements.

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