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Query: UMLS:C0024523 (malabsorption)
 7,319 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 58-year-old patient suffered from severe malabsorption due to agammaglobulinemia. Treated empirically with salicylazosulfapyridine 2--6 g/day, the subjective and objective features of malabsorption regressed. About a year after this treatment she developed a generalized weakness without renewal of the diarrhea; the diagnosis of Heinz body hemolytic anemia was established. In our patient, hemolysis began many months after the commencement of treatment and no deficiency of G6PD or other erythrocyte enzyme or pathological hemoglobin were found.
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PMID:Salicylazosulphapyridine-induced Heinz body anemia. 2 55

The use of elevated dosages of vitamin E in humans has led to the discovery of vitamin E deficiency syndromes in neurological areas. This evidence comes from careful clinical studies in which elevated vitamin E dosages were applied. In long-term studies it has now been established that retinal and neurological abnormalities are due to vitamin E deficiency and can be ameliorated by therapy with a large amount of the vitamin enterally or parenterally, which can possibly completely prevent the development of clinical manifestations if adequate treatment is given from an early age. It has also become clear that similar neurological and ocular lesions occur in other chronic fat malabsorptive states such as cholestatic liver diseases, cystic fibrosis, and extensive resection of the gut, with respect to an elevated dosage of vitamin E therapy. More recently, several patients with spinocerebellar degeneration from vitamin E deficiency without other evidence of malabsorption have been reported on in whom the progression of the diseases is cessated by the vitamin E therapy. Whether or not the use of elevated dosages of vitamin E should be recommended for certain diseases in premature infants is controversial. Previously, it has been thought that newborn infants, especially premature infants, suffer from vitamin E deficiency, because of their low plasma vitamin E concentrations and high susceptibility of erythrocytes to hydrogen peroxide hemolysis test. Furthermore, tocopherol deficiency has been implicated in four neonatal conditions: anemia of prematurity, retrolental fibroplasia (RLF), bronchopulmonary dysplasia (BPD), and intraventricular hemorrhage (IVH). A hemolytic anemia, associated with thrombocytosis and edema, which is responsive to vitamin E therapy, is not well recognized and occurs in a minority of preterm infants, who were given high amounts of polyunsaturated fatty acids in their formula. However, prophylactic use of an elevated dosage of vitamin E to prevent anemia in the majority of premature infants is controversial. There is no evidence for beneficial effects in BPD. In addition, the prophylactic use of pharmacological dosages of vitamin E for prevention of RLF and IVH has also had conflicting results. In the course of therapy with elevated dosages of vitamin E, administered either orally, intramuscularly, or intravenously, many problems arose in the infants, such as unexpected death, increased frequency of necrotizing enterocolitis (NEC) and sepsis, and the development of unusual symptoms including hepatic injuries.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Use and safety of elevated dosages of vitamin E in infants and children. 250 8

Infants are born with low tissue stores of tocopherol and accumulate this vitamin from feedings after birth. If prolonged malabsorption of tocopherol occurs, a recognized hemolytic anemia and spinocerebellar degeneration develops after a period of months to years. This is preventable with tocopherol supplementation. However, a benefit of tocopherol supplementation in premature infants who are transiently unable to feed after birth has been harder to prove. Pharmacologic doses have not definitively been shown to be beneficial in any of the putative oxygen toxicity syndromes, with the possible exception of PV/IVH. It is exciting that tocopherol appears to reduce significantly the incidence and severity of IVH, and this potential application underscores the urgent need for pharmacologic studies of this lipid nutrient. In order to administer the drug safely, we must establish the best means of assessing sufficiency and toxicity in premature infants. Measures of tissue capacity to resist oxidative stress appear to be the most promising of these tests at this time. In the interim, a working proposition is to provide sufficient tocopherol to these infants to raise the plasma levels into the range considered normal for term, breastfed infants.
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PMID:The role of vitamin E therapy in high-risk neonates. 306 10

Nutritional status of 86 patients with dermatitis herpetiformis (DH) was defined by anthropometric measurements and hematological and biochemical laboratory tests to establish prevalence of malabsorption and malnutrition. Anthropometric measurements in DH patients were comparable to normal control patients. Four individuals were of short stature; two had had diarrhea and failed to thrive in childhood. Abnormalities attributable to nutritional deficiency were detected in only 6 of the 86, whereas drug-associated hematological or biochemical changes were present in 36 of 55 subjects treated with dapsone or sulfapyridine. Twenty patients had hemolytic anemia or macrocytosis related to drug therapy. Only two had anemias attributable to malabsorption; one was iron deficient, the other folate deficient. Two other patients were mildly Fe deficient and two had slight folate deficiency; they lacked other stigmata of malabsorption. Drug-induced hematological and biochemical abnormalities were more common than changes that suggest nutritional disease, even though most DH patients had an enteropathy at presentation.
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PMID:Nutritional status in patients with dermatitis herpetiformis. 340 14

Two cats with intestinal malabsorption developed a hemorrhagic diathesis. Although unsubstantiated, the probable cause of bleeding was a chronic malabsorption of fat and the fat-soluble vitamin K. When treated with vitamin K1 per os, one cat's clotting times were only partially corrected. Since vitamin K1 is actively absorbed in the proximal small intestine, the incomplete response of this case to orally administered vitamin K1 was predictable. The infrequent occurrence of bleeding in animals with malabsorption is, in part, attributable to the ileal and colonic absorption of bacterially derived vitamin K2. For this reason, nonspecific use of antibiotics in these animals is contraindicated. Since long-chain, polyunsaturated fats impair vitamin K absorption, dietary fat given to animals with malabsorption should be restricted to medium- and short-chain, saturated fats. Vitamin K should be administered subcutaneously to these animals if prolonged clotting times or active bleeding is present, and routinely prior to surgery. Oral supplementation with vitamin K3, which is absorbed in the colon and less lipid soluble than vitamin K1, should be given to animals with malabsorption that are maintained as outpatients. Adequate dosage levels of vitamin K3, however, are yet to be established for the cat, and dose-dependent hemolytic anemia is a probable toxic manifestation.
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PMID:Probable vitamin K--deficient bleeding in two cats with malabsorption syndrome secondary to lymphocytic-plasmacytic enteritis. 350 99

Certain owl monkeys (AOT) develop spontaneous hemolytic anemia that responds to vitamin E. The anemia is associated with red blood cell lipid peroxidation and altered red blood cell membrane lipid composition. To investigate these changes, plasma lipid and lipoprotein profiles were characterized in anemic, anemia-susceptible, and anemia-resistant AOT. The plasma vitamin E and vitamin A concentrations were assessed as an index of fat absorption and the effect of corn oil supplementation and vitamin E-selenium injection were measured. Anemia-susceptible AOT had depressed plasma levels of vitamin E and A and an altered lipoprotein metabolism characterized by elevated ratios of low/high density lipoprotein cholesterol and free to esterified cholesterol in these lipoproteins. Vitamin E-selenium injection in anemia-susceptible AOT increased the plasma vitamin E, and vitamin E and corn oil supplements reduced the high density lipoprotein free to esterified cholesterol ratio. The data suggest that the AOT suffer from fat malabsorption and that the consequences (including tocopherol deficiency) result in altered cholesterol metabolism.
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PMID:Altered lipoprotein metabolism in spontaneous vitamin E deficiency of owl monkeys. 641 97

We made clinical and immunologic observations of 30 children with common variable hypogammaglobulinemia. The mean age at diagnosis was 10.5 years, five years after clinical onset. Diagnosis was initially made based on a history of recurrent otobronchopulmonary infections, diarrhea, or both. The most common complications included short stature, bronchiectasis, and malabsorption, often associated with giardiasis or sprue. Nine patients had associated autoimmune diseases (eg, atrophic gastritis, arthritis, and hemolytic anemia). Three patients died, one of chronic respiratory insufficiency, one of chronic persisting hepatitis, and one of osteogenic sarcoma. Humoral and cellular immune functions of all patients were examined.
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PMID:Common variable hypogammaglobulinemia in children. Clinical and immunologic observations in 30 patients. 660 51

All patients at Children's Hospital Medical Center who had ultrasonic evidence of cholelithiasis during the period from June 1979 to June 1982 were identified. Their charts and radiographs were reviewed, as were the surgical and pathologic reports of those who had cholecystectomy. Cholelithiasis was found to be less rare than expected. Sixty-five patients were identified during the three-year period. Exclusion of 13 patients more than 21 years old left 52 patients, 29 of whom were female and 23 male, ranging in age from 3 months to 21 years. Predisposing diseases or circumstances were present in 83 per cent of the cases. These included hemolytic anemia (15), cystic fibrosis (4), metabolic disease (3), liver disease (4), postpartum state (4), prior bowel resection or malabsorption (4), cardiac disease (4), prior orthopedic surgery (2), other (3). There were only nine cases in which no identifiable predisposition to cholelithiasis could be found. Although the gallstones were not subjected to chemical analysis, at least 53 per cent of them were visible on the 34 available abdominal radiographs, indicating the presence of calcium and thus stones of a mixed type.
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PMID:Cholelithiasis in children: recent observations. 664 68

The syndrome of nodular lymphoid hyperplasia of the small bowel with hypogammaglobulinemia is one of the hypogammaglobulinemic enteropathies. Chronic diarrhea and malabsorption are the most characteristic features of this disease, and they are frequently associated to hypogammaglobulinemia of various types (acquired, congenital non sex-linked) and to selective IgA deficiency. The immunological deficiency gives rise to the more characteristic features of the disease, namely: a) hypogammaglobulinemia; b) respiratory infections and dental caries; c) Giardia lamblia infestation of the small bowel; d) the characteristic radiological features; and, e) the histological aspect of the intestinal mucosa with absence of plasma cells. Periodical follow-up is needed because of the increased incidence of tumors in immunological deficiency states. A new case of nodular lymphoid hyperplasia associated to hemolytic anemia and granulomatous hepatitis is reported, and its possible pathogenesis is discussed.
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PMID:[Nodular lymphoid hyperplasia of the small bowel with IgA deficiency and hemolytic anemia (author's transl)]. 742 63

Using slight modifications to the method of Kohn, Mollin, and Rosenbach (1961) the histidine loading test has been carried out in 210 pregnant women. Seventy per cent. of the cases showed complete haematological correlation and this rose to 87% when marrow puncture was performed. False positive results occurred in some cases showing active erythropoiesis in response to iron therapy. False negative results were noted when other complications in addition to anaemia were present, and it was felt that these might interfere with the metabolism of histidine. In some cases the histidine test anticipated the haematological change.Seventy-seven per cent. of women with multiple pregnancies showed evidence of folic acid deficiency. Only in a few cases was the test positive before the 25th week of pregnancy. These were either cases of multiple pregnancy, haemolytic anaemia, malabsorption syndrome, or women with a recent history of megaloblastic anaemia of pregnancy. The test appears to confirm the significance of white cell changes as an indication of folic acid deficiency in pregnancy.
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PMID:PRACTICAL EVALUATION OF THE FIGLU TEST IN PREGNANCY WITH SPECIAL REFERENCE TO THE WHITE CELL CHANGES. 1430 45


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