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)

We evaluated the bentiromide test by analyzing para-aminobenzoic acid (PABA) in plasma and urine (a) for the identification of patients with complete pancreatic insufficiency and (b) as an alternative to the secretin-cholecystokinin test. Nine control subjects, 18 patients with cystic fibrosis, and 4 patients with Shwachman's syndrome were studied. Based upon the secretin-cholecystokinin test, pancreatic function was judged to be less than 0.1% of normal in 7 patients with cystic fibrosis and malabsorption and between 0.7% and 90% of control values in 11 patients with cystic fibrosis and 4 patients with Shwachman's syndrome without malabsorption. The bentiromide test was performed in two stages: first with bentiromide alone, then with equimolar free PABA. After ingestion of free PABA, the plasma profile and urinary excretion of PABA were comparable in controls, patients with cystic fibrosis, and patients with Shwachman's syndrome. Thirty minutes after oral bentiromide, plasma PABA values in patients with and without malabsorption were significantly lower than in the control group. From 60 to 180 min after ingestion, plasma PABA levels in patients without malabsorption were no different from controls; whereas levels in patients with malabsorption were significantly lower than in controls and in those without malabsorption, reaching the highest significance at 90 min. Similar results were obtained when the urinary excretion of PABA was considered. Only the 90-min plasma test reliably detected cystic fibrosis patients with steatorrhea, however. Duodenal colipase output was highly correlated with both the 90-min plasma test and the urinary excretion of PABA, with similar results for lipase and trypsin output. Reliable detection of pancreatic dysfunction, nevertheless, was not obtained even with the plasma test, in cystic fibrosis patients with greater than 5%-10% of the mean normal enzyme output. In patients with Shwachman's syndrome, none of whom had malabsorption, the plasma and urinary test failed to detect pancreatic dysfunction even with enzyme output as low as 1% of normal.
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PMID:Bentiromide test for assessing pancreatic dysfunction using analysis of para-aminobenzoic acid in plasma and urine. Studies in cystic fibrosis and Shwachman's syndrome. 387 4

Hyporeninemic hypoaldosteronism occurred in a 49-year-old man with chronic endocrine and exocrine pancreatic insufficiency secondary to pancreatectomy and in a 64-year-old man with recurrent pancreatitis, exocrine pancreatic insufficiency, and prolonged magnesium deficiency. Hyporeninemic hypoaldosteronism has never, to our knowledge, been reported in these clinical settings before and may be masked by the malabsorption of pancreatic insufficiency.
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PMID:Hyporeninemic hypoaldosteronism. New associations. 389 83

To determine the relative role of malabsorption as the cause of decreased linoleic acid in blood and tissue lipids of patients with cystic fibrosis (CF) and pancreatic insufficiency, the increase in plasma linoleic acid was determined after ingestion of various lipid supplements. CF patients with documented pancreatic insufficiency and normal control subjects were given each of four different lipid supplements on separate days (a minimum of 3 days apart). The supplements were commercial safflower oil, Microlipid, Captex 810D, and Captex 810B. Fasting subjects consumed 36 g of lipid in a milk shake containing 15 g of protein and 45 g of carbohydrate. Plasma samples obtained at 0, 2, 4, 6, and 8 h after the meal showed that CF patients absorbed linoleic acid from all of the lipid preparations tested when administered with their regular dose of pancreatic enzyme supplement. The mean maximal increase in percent plasma linoleic acid in CF patients was not different from controls after ingestion of safflower oil, Microlipid, and Captex 810B. With Captex 810D the CF patients had a significantly higher increase in percent plasma linoleic acid than controls, 6.75% vs. 2.27%, respectively, at 2 h (p less than 0.01), and 11.10% vs. 4.65% at 8 h (p less than 0.01). The CF patients also appeared to absorb the Captex products faster than controls, suggesting that presence of medium chain length fatty acids in these structured lipids facilitated their utilization by CF patients. The results indicate that malabsorption alone cannot account for the inadequate or marginal essential fatty acid status of CF patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Linoleic acid absorption from lipid supplements in patients with cystic fibrosis with pancreatic insufficiency and in control subjects. 398 68

A 20-year-old male patient with cystic fibrosis (CF) is described, who acutely developed hypoalbuminemia concurrently with giardiasis. Hypoalbuminemia could not be explained by the usual causes seen in patients with CF, but resolved with quinacrine therapy. Subsequently, asymptomatic giardiasis was sought but not found by either the string test or stool exam in any of 15 patients with pancreatic insufficiency who were examined in a prospective manner. Although pancreatic insufficiency is felt to be able to act synergistically with giardiasis to accentuate malabsorption, patients with pancreatic insufficiency per se are not necessarily at greater risk for colonization with Giardia.
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PMID:Severe giardiasis in a patient with cystic fibrosis. 398 30

Forty-five patients, 1-37 years following gastric resection (B II n = 34, B I n = 11) underwent an oral pancreatic function test with fluorescein dilaurate (PLT). Out of this group 11 patients suffered from a chronic pancreatitis proven by specific examination. All patients with chronic pancreatitis had pathological PLT-test results. In the B II-patients without primary pancreatic disease there were pathological PLT-test results in 69.7% and 63.6% in the B I-patients, respectively. In the resected patients malabsorption was excluded by unchanged fluorescein-excretion pattern following oral ingestion of free fluorescein. The results indicate a secondary pancreatic insufficiency following distal gastric resection. Patients with signs of malnutrition after gastric resection should undergo an indirect pancreatic function test. Substitution therapy with pancreatic enzymes is indicated following evaluation of exocrine function impairment.
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PMID:[Secondary pancreatic insufficiency following distal stomach resection]. 409 13

Hog pancreas was subfractionated and assessed for its ability to correct vitamin B(12) malabsorption in patients with pancreatic dysfunction and in rats with partial pancreatic extirpation. The constituent obtained from the pancreas that increased vitamin B(12) absorption in both humans and rats was soluble at 50,000 g, heat labile, acid stable, and approximately 20,000-25,0000 in molecular weight. The active subfractions contained tryptic and chymotryptic but no amylase or lipase activity. Thrice-crystallized trypsin corrected the vitamin B(12) malabsorption in both patients with pancreatic insufficiency and in rats with subtotal pancreatectomy. These data indicate that pancreatic proteolytic enzymes-in particular, trypsin-are necessary for optimal vitamin B(12) absorption.
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PMID:Trypsin-like nature of the pancreatic factor that corrects vitamin B12 malabsorption associated with pancreatic dysfunction. 471 58

The tubeless for diagnosing exocrine pancreatic insufficiency using Fluorescein-Dilaurate was first applied to children of three years and younger, and to children with malabsorption and/or maldigestion. Fluorescein-Dilaurate in this test is an indication for the excretion of the pancreas-specific arylesterases. The dosage and the amount of liquid to be drunk by adults were reduced. It was shown that - applied to children of more than three years- reliability and validity of the test were not perceptibly influenced by the practise modifications and by the existing malabsorption/maldigestion. The applicability of this method to children of three years and younger depends on the observance of certain rules. Thereby, the test becomes sufficiently practicable also in children of three years and younger.
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PMID:[Diagnosis of pancreatic insufficiency using fluorescein-dilaurate in children (author's transl)]. 611 15

The mucosal concentrations of seven regulatory peptides and the density properties and integrity of their storage granules have been studied in mucosal biopsies from the human jejunum in eight gastrointestinal disease states and compared with normal controls. In diseases with associated mucosal inflammation (coeliac disease, Crohn's disease with jejunal involvement, postinfective tropical malabsorption, and common variable immunodeficiency) there was a selective increase in fragility of the gastric inhibitory polypeptide (GIP) and somatostatin storage granules. The gastrin, motilin, enteroglucagon, secretin, and vasoactive intestinal polypeptide granules had normal properties in these conditions. In diseases in which diarrhoea occurred in the absence of changes in jejunal mucosal histology (irritable bowel syndrome, pancreatic insufficiency, jejuno-ileal bypass for morbid obesity, and purgative abuse) there were no abnormalities of the storage granules. Increased mucosal concentrations of all peptides except vasoactive intestinal polypeptide (VIP) were found in coeliac disease and selective increases of VIP found in Crohn's disease, motilin in the irritable bowel syndrome and gastrin and GIP in pancreatic insufficiency. It is suggested that the storage granule abnormalities in the diseases with abnormal mucosal histology are secondary to the inflammatory changes.
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PMID:Gastrointestinal regulatory peptide storage granule abnormalities in jejunal mucosal diseases. 614 62

In many ways diagnosis of pancreatic disorders in children is difficult. Since pancreatic parameters are age-dependent, reliable laboratory parameters are not easily established. Children are less likely than adults to endure tolerance tests and invasive test methods should therefore be used only in special situations. Estimation of chymotrypsin in faeces seems to be an earlier indicator of pancreatic insufficiency than the PABA-peptide-test. A secretin-pancreozymin test can only be advised for first diagnosis after screening has repeatedly indicated pathological values and malabsorption has more or less been ruled out. A threefold rise in serum amylase values - matched for age - suggests pancreatitis and sonography should then be applied to obtain further clarification.
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PMID:[Diagnosis of pancreatic diseases in childhood (author's transl)]. 616 3

Exocrine pancreatic insufficiency usually does not develop before reduction of enzyme output by more than 90%. Patients with pancreatic insufficiency have a ravenous appetite but fail to thrive from malnutrition. The caloric deprivation is primarily due to fat malabsorption, recognized by the passage of bulky foul smelling greasy stools. Several isolated enzyme deficiencies can be separated from diseases with generalised pancreatic insufficiency. Under replacement therapy with pancreatic enzyme supplements most patients improve and gain weight, although fat and bile acid malabsorption are not abolished.
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PMID:[Exocrine pancreatic insufficiency (author's transl)]. 616 4


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