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Query: UMLS:C0017536 (giardiasis)
 1,714 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The diagnoses which may be arrived at by examination of peroral small bowel mucosal biopsy specimens are presented. Celiac sprue, unclassified sprue (refractory sprue), infectious gastroenterititis, stasis syndrome and kwashiorkor have a severe mucosal lesion. Other clinical conditions are required to establish the diagnosis in these diseases. A number of diseases have specific diagnostic features. Included are Whipple's disease, abetalipoproteinemia, collagenous sprue, primary intestinal lymphoma, eosinophilic gastroenteritis, giardiasis, coccidiosis, strongyloidiasis, lymphangiectasis and the intestinal immunodeficiency diseases. Mucosal abnormalities may be present in other diseases but the diagnoses are usually made on other criteria than small bowel biopsy. These include vitamin B12 or folic acid deficiency, Crohn's disease, gastrinoma, acrodermatitis enteropathica, amyloidosis, chronic granulomatous disease, lipid storage diseases, histoplasmosis, capillariasis, cytomegalovirus infection, schistosomiasis and macroglobulinemia.
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PMID:Histologic diagnosis of diseases of malabsorption. 51 56

A 36-year-old man, with a history of recurrent respiratory infection, dermatomycosis, arthralgia and abnormal stools for 12 years, developed a febrile illness (up to 40 degrees C). A Serratia marcescens septicaemia responded to antibiotics. Four months later cervical and abdominal lymph-adenopathies were noticed. Cervical lymph node biopsy revealed lymphadenitis with epithelioid cell nests. Duodenoscopy with biopsy demonstrated Whipple's disease associated with lambliasis. Electron-microscopy showed rod-shaped bacteria typical of Whipple's disease, and Giardia lamblia. Using the polymerase chain reaction, Whipple-specific DNA fragments of 284 base pairs from the genome of the Whipple bacterium (Tropheryma whippelii) were demonstrated. Antibiotic treatment with Ampicillin (2 g three times daily) and ceftriaxone (2 g once daily) i.v. for 21 days, followed by oral ofloxacin (200 mg daily) and co-trimoxazole (three times daily 800 mg sulfamethoxazole and 160 mg trimethoprim), brought about remission of Whipple's disease. Long-term antibiotic treatment was continued with co-trimoxazole. Lambliasis recurred after 3 and 5 months, despite treatment with metronidazole, 250 mg three times daily for 7 days.
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PMID:[Whipple's disease associated with opportunistic infections]. 768 63

Hydrogen breath tests (H2 BT) have been used extensively to investigate intestinal disaccharidase deficiencies. A potentially useful test for assessing intestinal absorptive function, the H2 BT with D-xylose (H2 BT-D-xylose), has received scant attention. We report here the results of our investigation of this test in 45 patients. Fifteen patients had proved malabsorption that was due to nontropical sprue in nine, and to lymphoma, Whipple's disease, or giardiasis in the remainder. Nine patients had small-bowel bacterial overgrowth secondary to either postsurgical sequelae or intestinal dysmotility. Twenty-one patients with irritable bowel syndrome and 21 healthy individuals served as control groups. All participants ingested 25 g of D-xylose, and alveolar breath samples were obtained thereafter at 30 min intervals for 5 hr. Breath H2 was measured by chromatography. Basal H2 production, peak change (delta) and area under the curve (AUC) were calculated. Simultaneously, 5-hr urinary excretion of D-xylose was measured by colorimetry and served as the reference test. In healthy individuals, D-xylose ingestion increased H2 production (delta = 5.8 +/- 1.4 ppm, P < 0.001). Changes were similar in patients with the irritable bowel syndrome. In contrast, the increase was of a much greater magnitude in the malabsorption group (delta = 49.9 +/- 7.2 ppm, P < 0.001 vs healthy controls). AUC analysis yielded comparable results. Test performance analysis showed that, in malabsorption the H2 BT-D-xylose had a sensitivity index of 0.86, which was identical to that of the urinary D-xylose test. Specificity was 1 and 0.95, respectively; and predictability 1 and 0.93, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Potential usefulness of hydrogen breath test with D-xylose in clinical management of intestinal malabsorption. 842 44

Both pathologists and gastroenterologists are one team working up patients with suspected small bowel diseases. Both have to try to recognize the various entities of disorders found in the small bowel. Some diseases, such as Whipple's disease, are histologically easily recognized by their specific changes. Others, however, show unspecific histological changes and may only be recognized by a certain pattern of inflammatory infiltration of the mucosa and/or by architectural changes. In the present paper giardiasis with its diagnostic trophozoites, Crohn's disease and celiac disease with their typical inflammation and mucosal architecture and their differential diagnoses are discussed. A modified Marsh classification is given, which allows to report the various types of celiac lesions more precisely. Furthermore, the variations found in the normal mucosa are presented. In particular, the presence of lymphocytes and plasma cells in the lamina propria is shown to be a part of the mucosa associated lymphatic tissue (MALT). The importance of giving a clear statement on the etiology of the disease whenever possible is stressed.
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PMID:[Biopsy differential diagnosis of non-cancerous small intestinal diseases]. 1071

Whipple's disease is an uncommon systemic disease caused by the recently cultured Tropheryma whippelii, classically presenting with gastrointestinal symptoms. We report a patient with weight loss and malabsorption in which Whipple's disease and concurrent Giardia lamblia infection were diagnosed. Moreover, multiple small bowel polyps were present. The relationship between concurrent Whipple's disease and Giardia lamblia infection is discussed.
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PMID:Concurrent Whipple's disease and Giardia lamblia infection in a patient presenting with weight loss. 1171 Dec 78

The gastrointestinal tract possesses a huge epithelial surface area and performs many different tasks. Amongst them are the digestive and absorptive functions. Disorders of intestinal absorption and secretion comprise a variety of different diseases, e.g. coeliac disease, lactase deficiency or Whipple's disease. In principle, impaired small intestinal function can occur with or without morphological alterations of the intestinal mucosa. Therefore, in the work up of a malabsorptive syndrome an early small intestinal biopsy is encouraged in conjunction with breath tests and stool analysis to guide further management. In addition, there is an array of functional tests, the clinical availability of which becomes more and more limited. In any case, early diagnosis of the underlying pathophysiology is most important, in order to initiate proper therapy. In this chapter, diagnostic procedure of malabsorption is discussed with special attention to specific disease like coeliac disease, Whipple's disease, giardiasis and short bowel syndrome. Furthermore, bacterial overgrowth, carbohydrate malabsorption and specific nutrient malabsorption (e.g. for iron or vitamins) and protein-losing enteropathy are presented with obligatory and optional tests as used in the clinical setting.
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PMID:Disorders of intestinal secretion and absorption. 1950 67

This review describes the gasterointestinal entities, their pathophysiology, clinical presentation, diagnostic workup and therapy that typically involve weight loss as the major presenting symptom. The differentiation of malassimilation into maldigestion and malabsorption is clinically mostly not helpful. Instead primary malasssimilation can be distinguished from secondary due to another disease. Celiac disease, lambliasis, small bowel CD, CVIDS and Whipple's disease result in loss of absorptive surface. Chronic intestinal pseudobstruction leads to weight loss through dysmotility and postprandial pain. Microscopic colitis involves some weight loss and needs to be considered because of its high prevalence. Exocrine pancreatic insufficiency and the various protein loosing enteropathies may be primary or secondary syndromes. Dumping, bile acid malabsorption and short bowel syndrome occur after typical operative procedures. Chronic radiation enteritis, chronic intestinal ischemia and intestinal diabetic polyneuropathy are due to chronic intestinal injury.
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PMID:[Gastrointestinal causes of weight loss: clinical presentation, diagnostic workup and therapy]. 2688 38