Disease relevance of Sprue, Tropical

• Since clinical and biochemical improvement only occurred on treatment with tetracycline when enterobacteria were eliminated from the mucosa, it is suggested that these organisms may be responsible for persisting jejunal abnormalities in tropical sprue [1].
• Peptide YY levels were found to be grossly elevated in patients with steatorrhea due to small intestinal mucosal atrophy (tropical sprue) [2].
• One patient (2.2%) had partially treated tropical sprue; six patients (14%) had disorders of immune regulation including Hashimoto's thyroiditis (n = 2) and one case each of Graves' disease, rheumatoid arthritis, psoriasis, and multiple sclerosis; and six patients (14%) were on nonsteroidal anti-inflammatory drugs (NSAIDs) [3].
• Since CD and tropical sprue (TS) have similar intestinal functional and histological pattern of injury and that an increased inflammatory response has been reported to occur in patients with irritable bowel syndrome (IBS), liver involvement might be expected to occur either in TS or IBS [4].

High impact information on Sprue, Tropical

• In 27 Puerto Rican patients with tropical sprue proven by intestinal biopsy and clinical response to folic acid, HLA type was determined with a microcytotoxicity assay [5].
• Absorption of water and sodium and activity of adenosine triphosphatases in the rectal mucosa in tropical sprue [6].
• PP response to the meal was normal in 10 patients with active coeliac disease and 12 patients with acute tropical sprue with steatorrhoea [7].
• In subjects with vitamin B12 malabsorption due to tropical sprue, the results were identical with the control subjects [8].
• The degree of essential fatty acid depletion observed is unlikely to be the cause of the mucosal accumulation of triglyceride in tropical sprue [9].

Chemical compound and disease context of Sprue, Tropical

• Patients with tropical sprue had decreased levels of plasma linoleic acid, raised monoenoic fatty acids and the appearance of 5,8,11-eicosatrienoic acid in the lecithin fraction [9].
• If these and other gastrointestinal insults, such as tropical sprue, small bowel overgrowth, lactose intolerance, and processes unrelated to travel are excluded by more invasive studies or clinical history, the patient can be reassured that idiopathic chronic diarrhea is usually self-limited [10].
• When the xylose test is used in tropical countries the effect of systemic infections on the result must be careful evaluated, otherwise tropical malabsorption ('tropical sprue') might be diagnosed erroneously [11].
• Although hypoalbuminaemia was present in 66% of patients with tropical sprue, in only one case was an increase in jejunal calibre associated with a serum albumin concentration below 27 g/l, the threshold below which jejunal dilatation occurs in hypoalbuminaemia alone [12].
• The presence of a higher percentage of the dose in the plasma as HCC-3H after the intravenous and oral administrations in the tropical sprue subjects when compared to controls indicates that the diseased state does not alter vitamin D3 metabolism [13].

Anatomical context of Sprue, Tropical

• Previous studies indicated that many patients with tropical sprue in southern India have triglyceride accumulation within the cells of the intestinal mucosa [9].
• Although pancreatic hyposecretion has been reported in patient with tropical sprue when indirect stimulation with Lundh meal was applied to pancreas, yet on direct stimulation with secretin, we found pancreatic functions to be normal [14].

Gene context of Sprue, Tropical

• Autoantibodies to duodenal gastric-inhibitory-peptide (GIP) cells and to secretin (S) cells in patients with coeliac disease, tropical sprue and maturity-onset diabetes [15].
• Of twelve tropical sprue sera, four reacted with the same two cells [15].
• Other key issues raised by the case include the vanishing incidence of tropical sprue, an entity to which most clinicians would have mistakenly attributed this malabsorptive syndrome arising in a traveler, and the under-recognition of the protean manifestations of celiac sprue, to which we would add persistent travelers' diarrhea [16].

Analytical, diagnostic and therapeutic context of Sprue, Tropical

• Pteroylglutamic acid (PGA) absorption was assessed in ten untreated tropical sprue (TS) and eight control subjects utilizing a marker perfusion technique [17].
• Assessment of vitamin B12 absorption in tropical sprue utilizing a whole body counter [18].

References