Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0024523 (malabsorption)
 7,319 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A patient is presented who developed a granulomatous hepatitis and pleuritis approximately 7 months after an ileal bypass procedure for morbid obesity. Although the etiological agent was presumed to be Mycobacterium tuberculosis no pathogenic organism was grown from the liver, pleura, bone marrow, sputum, or gastric aspirate. The possibly increased susceptibility of these patients to mycobacterial infections is discussed. The value of obtaining serum levels of ethambutol, isoniazid, and rifampin, in patients with malabsorption is stressed. Although this patient seemed to respond to antituberculous therapy, other possible causes for the granulomatous process are explored.
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PMID:Granulomatous hepatitis and pleuritis after ileal bypass for obesity. 71 72

To define the extent and nature of mycobacterial infection in patients on an adult dialysis unit whose catchment population contains a large proportion of non-Caucasian subjects, a retrospective survey of all new patients accepted onto our maintenance dialysis programme between January 1987 and December 1989 was carried out. Twenty-six Asian, 13 Afro-Caribbean, two Oriental and 170 Caucasian patients were accepted onto the dialysis programme in the three-year recruitment period. Eight of the 26 Asian patients, but none of the others, had developed mycobacterial infection by the end of December 1990. One patient had a cerebral tuberculoma with miliary mottling on chest X-ray, one pulmonary tuberculosis, one tuberculous adenitis and 5 tuberculous peritonitis (four due to Mycobacterium tuberculosis and one Mycobacterium kansasii). All the patients had been living in the UK for an average of 15 (range 6-24) years, with no known recent exposure to tuberculosis. Five patients are now alive and well, one developed malabsorption following M. kansasii peritonitis, but two with tuberculous peritonitis died before treatment could be instituted. Mycobacterial infections were associated with a high level of mortality and morbidity. No Asian patient developed mycobacterial infection during post-transplant immunosuppressive therapy in the study period, probably because of the routine anti-tuberculous chemoprophylaxis employed in this group of patients. The diagnosis of mycobacterial infection should be suspected when an Asian dialysis patient develops a pyrexia of unknown origin. It is likely, though not proven, that anti-tuberculous chemoprophylaxis might reduce this high incidence of tuberculous infection in Asian dialysis patients.
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PMID:Mycobacterial infection is an important infective complication in British Asian dialysis patients. 168 37

At endoscopy, a 30-year-old man with acquired immune deficiency syndrome (AIDS), Kaposi's sarcoma, diarrhea, and unexplained malabsorption showed erythematous macular duodenal lesions consistent with Whipple's disease by histology and electron microscopy. Symptoms did not respond to tetracycline. Subsequent cultures revealed systemic Mycobacterium avium (M. avium) infection. Tissue from this patient, from patients with Whipple's disease and from a macaque with M. avium were compared. All contained PAS-positive macrophages but M. avium could be distinguished by positive acid-fast stains and a difference in pattern of indirect immunofluorescence staining with bacterial typing antisera. PAS-positive macrophages in the intestinal lamina propria are no longer pathognomonic of Whipple's disease. Ultrastructural and histological similarities between Whipple's disease and M. avium infection suggest that both are manifestations of immune deficits limiting macrophage destruction of particular bacteria after phagocytosis. M. avium must be considered in the differential diagnosis of diarrhea in patients with AIDS and other immunosuppressed conditions.
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PMID:Intestinal infection with Mycobacterium avium in acquired immune deficiency syndrome (AIDS). Histological and clinical comparison with Whipple's disease. 258 Jun 79

This paper will describe a case series of 35 AIDS patients with infection of the gastrointestinal (GI) tract with Mycobacterium avium-intracellulare (MAIC). Thirty-five homosexual men with a mean age of 35 yr and a mean duration of AIDS of 7.7 months prior to the diagnosis of MAIC were investigated to determine the extent of MAIC infection. The investigations included upper endoscopy, sigmoidoscopy, liver biopsy, bone marrow aspiration and biopsy, stool and blood cultures for MAIC, and D-xylose absorption tests. Tissue biopsy material was examined by light microscopy with the Ziehl-Neelsen stain. The duodenum was most commonly involved (30/34 men), with 65% positive on special stains and 76% positive on culture of biopsy tissue. Unusual fine white nodules, believed to be characteristic for duodenal MAIC infection, were observed in 12 men. Esophageal (two men), liver (two men), and rectal involvement (seven men) were found. In nine of 18 men (50%), the D-xylose test was abnormal. In 28 of 33 men (85%), blood cultures grew MAIC. Similarly, in 25 of 28 men (89%), bone marrow biopsies grew MAIC, and in 18 of 21 men (86%) stool samples grew MAIC. We conclude that GI tract infection with MAIC in AIDS patients is frequently associated with systemic infection with the agent. Duodenal involvement is common, and may be accompanied by a characteristic gross lesion, that of fine white nodules on the mucosa. Malabsorption, as determined by the D-xylose test, is not a universal finding, as has been reported previously.
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PMID:Atypical mycobacterial infection of the gastrointestinal tract in AIDS patients. 259 53

Nontuberculous mycobacteria (NTM) have been frequently identified as opportunistic pathogens in individuals with advanced human immunodeficiency virus (HIV) infection. The majority of these infections have been caused by members of the Mycobacterium avium-intracellulare complex (MAC). Disseminated MAC infection has generally been diagnosed late in the course of HIV infection, and it is often associated with persistent nonspecific symptoms of fever, generalized weakness, and weight loss. Abdominal pain and/or diarrhea with malabsorption may also occur in some patients. Despite frequent isolation of MAC organisms from respiratory secretions in these patients, significant pulmonary involvement has not been seen commonly with disseminated MAC infection. While MAC can be isolated from a variety of clinical specimens in infected individuals, culturing of blood is the single most useful diagnostic procedure to evaluate for MAC infection. The prognosis for disseminated MAC infection in HIV-infected patients has been poor, with a reported median survival of 7.4 months after diagnosis. The overall contribution of MAC infection to mortality in these patients has not been clearly delineated. Treatment of MAC infection in HIV-infected individuals using a variety of drug regimens has not been effective in clearing mycobacteremia or improving overall survival in the majority of patients. However, initiation of drug therapy for MAC may decrease the severity of disease symptoms in some patients. Several NTM other than MAC have also been reported as causing infection in HIV-infected patients. Many of these organisms are ubiquitous in the environment and are frequent colonizers of biologic specimens. Although many NTM are regarded as relatively avirulent, these organisms need to be recognized as potentially important pathogens in HIV-infected patients with significant immunosuppression.
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PMID:Mycobacterium avium complex and other nontuberculous mycobacteria in patients with HIV infection. 266 36

In addition to abnormalities in systemic immune function, patients with the acquired immunodeficiency syndrome (AIDS) and the pre-AIDS syndromes have significant abnormalities in the distribution of T-cell subsets in the intestinal tract. Such immune deficits predispose such patients to opportunistic infections and tumors, many of which involve the gastrointestinal tract. For example, Candida albicans often causes stomatitis and esophagitis. Intestinal infections with parasites (Cryptosporidium, Isospora belli, Microsporidia) or bacteria (Mycobacterium avium-intracellulare) are associated with severe diarrhea and malabsorption, whereas viruses like cytomegalovirus and herpes simplex virus cause mucosal ulcerations. Clinically debilitating chronic diarrhea develops in many AIDS patients for which no clear cause can be identified. Enteric pathogens like Salmonella and Campylobacter can be associated with bacteremias. Kaposi's sarcoma and lymphoma involving the intestinal tract are now well-recognized complications of AIDS. Although AIDS is not associated with a pathognomonic liver lesion, opportunistic infections and Kaposi's sarcoma or lymphoma may involve the liver.
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PMID:Gastrointestinal manifestations of the acquired immunodeficiency syndrome. 382 11

A 24-year-old man developed a severe pleuropulmonary infection with Mycobacterium kansasii 18 months after receiving a kidney transplant from his mother. Intestinal malabsorption with severe diarrhea and a skin abscess disappeared and his pneumonia was cured when Rifampin was administered. This suggested that generalized dissemination with M. kansasii may have been present.
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PMID:Pulmonary infection with M. kansasii in a renal transplant patient. 700 Dec 62

Infection with Mycobacterium intracellulare serotype 10 was diagnosed in 2 rhesus monkeys (Macaca mulatta) in a closed colony of 90 animals. The clinicopathologic presentation in 1 animal with advanced disease was characterized by a precipitous weight loss, therapeutically unresponsive diarrhea, anemia, weakness, prostration, refractory tuberculin tests (using mammalian old tuberculin and M bovis purified protein derivative tuberculin), and disseminated granulomas in the lungs, spleen, liver, kidneys, lymph nodes, salivary glands, and intestines. The lamina propria throughout the large and small intestines was infiltrated with mycobacteria-laden macrophages. Severe hypoproteinemia, hypoalbuminemia, hypoglobulinemia, mild hypocalcemia, and edema were compatible with a malabsorption-like syndrome. The 2nd animal was clinically normal, but a weak positive tuberculin reaction to M bovis purified protein derivative at 72 hours necessitated euthanasia. This animal's disease was characterized by microgranulomas in the lungs, bronchial lymph nodes, liver, and pancreas, without involvement of the gastrointestinal tract. There was no evidence of M intracellulare infection in the remaining 88 animals in the colony, as determined by mycobacterial cultures of tracheobronchial washings, additional tuberculin testing, thoracic radiography, and mycobacterial culture of the drinking water. Tuberculin testing and thoracic radiographs of personnel working with the nonhuman primates were also negative. These cases were considered to be important because both animals were infected with the same serotype and because there has been an increasing number of isolations of this organism in human infections throughout Massachusetts. Drug-sensitivity testing revealed the organism to be sensitive to cycloserine and resistant to isoniazid, rifampin, ethambutol, streptomycin, kanamycin, and pyrazinamide.
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PMID:Nontuberculous mycobacterial infection attributable to Mycobacterium intracellulare serotype 10 in two rhesus monkeys. 717 60

Infection due to Mycobacterium tuberculosis continues to plague humanity. In the United States, conditions have taken a decided turn for the worse, with an increasing frequency of infection and the spread of multiple-drug-resistant strains. A number of strategies are available to improve the management of this epidemic. Mycobacterium avium is now recognized as a significant cause of morbidity and mortality in patients with the acquired immunodeficiency syndrome. Therapy is limited due to relative drug resistance, drug intolerance, and drug malabsorption; however, potentially useful regimens are being developed.
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PMID:Mycobacterial infections. 830 90

To assess the prevalence of intestinal protozoans in French HIV-infected patients, stool samples, duodenojejunal biopsies, and/or colorectal biopsies from 81 patients were studied for parasites, viruses, and bacteria. Pathogens were found in 70.6% of AIDS patients with diarrhea or malabsorption. The respective prevalence of protozoa in AIDS patients with diarrhea was Cryptosporidium sp.: 37.3%, Blastocystis hominis: 13.7%, Giardia intestinalis: 5.8%, Isospora belli: 2%, Enterocytozoon bieneusi: 2%. Microsporidia were noted in one patient with severe malabsorption but no diarrhea. Other pathogens included cytomegalovirus in 27.4% and Mycobacterium avium in 5.8%. Patients with identified pathogens were more immunosuppressed and more severely malnourished than those with unexplained diarrhea. Multiple pathogens were found in 13 of 81 patients (16%). Twenty-six of 66 identified pathogens (40%) were diagnosed only on biopsy specimens. Chronic diarrhea in HIV patients could be explained in the vast majority by appropriate gastrointestinal investigations. Cryptosporidia played a major role, while microsporidia appeared to be less common.
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PMID:Prevalence of intestinal protozoans in French patients infected with HIV. 834 Aug 92


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