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

Deficiency of nutritional iron represents a public health problem recognized throughout much of the world. The overall prevalence rate of patients with iron deficiency (ID) who need supplementary iron therapy ranges markedly from less than 10% to as high as 70% among various ethnic and socioeconomic groups. Dermatologically, the iron-deficit state can be a secondary condition or trigger a wide range of mucocutaneous alterations. Early appreciation of adverse cutaneous manifestations of ID seems to have commensurate significance not only in predicting the presence of undiagnosed ID, but also for providing specified avenues for rational therapeutic approaches to patients with ID. Dermatopathic anemia has attracted the attention of clinicians because ID was found to be a metabolic consequence of skin diseases such as erythroderma, exfoliative dermatitis, psoriasis, eczema, and many others. Previous studies had suggested that iron may be lost in accelerated turnover of the keratinocyte from scaling; currently, malabsorption of iron is accepted implication accounting for dermatopathic anemia. However, mucocutaneous affections adversely manifested by ID have not been extensively reviewed and published in the current dermatologic literature because of the potentially benign course of the adverse conditions and the limited degree of clinical expression. Therefore, changes in hair, nails, mucosa and tongue, pruritus, chronically sustained inflammation, dermatitis herpetiformis, and photodermatitis are among the adverse cutaneous sequelae whose relation to ID are highlighted and discussed in the present review. Because of their clinical and diagnostic importance, other extracutaneous physical signs of ID, such as blue sclerae and pica, are also included in this review.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Iron deficiency: structural and microchemical changes in hair, nails, and skin. 176 60

Persistent pica may be either a cause or a result of iron deficiency. Three children are described with long-standing pica and iron-deficiency anemia and in whom total villous atrophy consistent with celiac disease was found on jejunal biopsy. Additional findings included short stature, delayed bone age, and impaired xylose absorption. A dramatic growth spurt and complete resolution of pica were observed after a gluten-free diet. In these cases pica evidently resulted from iron deficiency secondary to malabsorption. Underlying celiac disease should be considered in children with persistent pica and growth failure even if gastrointestinal disturbances are minimal.
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PMID:Pica as a presenting symptom in childhood celiac disease. 230 99

Three-hundred Aboriginal people five to 70 yr have been studied at three missions in the north west of Australia-Beagle Bay, Lombadina and One Arm Point. The prevalence of hypozincaemia and hypercupraemia (a departure of more than 2 S.D. from the expected normal) has been assessed. Plasma iron concentration was determined. Half of the individuals had hypozincaemia and for some age groups the prevalence was greater (almost 100% for 15 to 20-year-old females at Lombadina). Hypercupraemia was prevalent and ranged from 70 to 100% for most age groups. Hypoferraemia was detected frequently. By the use of anthropometric methods the children were found to be growth retarded and to have reduced weight for height. These people are known to be infected with intestinal parasites which cause bleeding into the bowel or malabsorption which can cause losses of zinc or failure of adsorption. They prefer unleavened bread which contains phytic acid which inhibits zinc absorption. The soil is zinc deficient and the climate conducive to large losses of zinc in sweat. Geophagia is practiced and pica is found to occur in children. Preliminary evidence of elevated copper status is available. We speculate that growth failure may be related to zinc deficiency or copper toxicity.
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PMID:Zinc, copper and environmental factors in the aboriginal peoples of the North West. 694 43

A study population consisting of 66 mentally retarded individuals, 60 with and six without pica, was evaluated for iron status, and for plasma and hair zinc, copper, and magnesium levels within a month of known dietary intake. The parameters were all within the normal range for individuals without pica. In contrast, subjects practicing pica had low plasma zinc and elevated plasma copper values as compared to those without pica. Plasma magnesium was in the low normal range for all individuals in the study population. Among the indicators of iron status measured, Hb, hematocrit, plasma iron, total iron-binding capacity, iron saturation, and plasma ferritin, several values were low (p less than 0.001). Depression in plasma zinc level was related to the type and severity of the pica. In plasma, zinc was positively correlated with iron and negatively correlated with copper. No relationships were found between dietary intakes and plasma levels of these minerals. The data suggest that malabsorption of zinc and iron were associated with some types of pica although the individuals received adequate dietary intake of minerals. Zinc, copper, and magnesium concentrations in hair were within normal ranges. Hair was a less sensitive indicator than plasma of trace element status.
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PMID:Pica and mineral status in the mentally retarded. 708 Oct 93

Intestinal parasites cause significant morbidity and mortality. Diseases caused by Enterobius vermicularis, Giardia lamblia, Ancylostoma duodenale, Necator americanus, and Entamoeba histolytica occur in the United States. E. vermicularis, or pinworm, causes irritation and sleep disturbances. Diagnosis can be made using the "cellophane tape test." Treatment includes mebendazole and household sanitation. Giardia causes nausea, vomiting, malabsorption, diarrhea, and weight loss. Stool ova and parasite studies are diagnostic. Treatment includes metronidazole. Sewage treatment, proper handwashing, and consumption of bottled water can be preventive. A. duodenale and N. americanus are hookworms that cause blood loss, anemia, pica, and wasting. Finding eggs in the feces is diagnostic. Treatments include albendazole, mebendazole, pyrantel pamoate, iron supplementation, and blood transfusion. Preventive measures include wearing shoes and treating sewage. E. histolytica can cause intestinal ulcerations, bloody diarrhea, weight loss, fever, gastrointestinal obstruction, and peritonitis. Amebas can cause abscesses in the liver that may rupture into the pleural space, peritoneum, or pericardium. Stool and serologic assays, biopsy, barium studies, and liver imaging have diagnostic merit. Therapy includes luminal and tissue amebicides to attack both life-cycle stages. Metronidazole, chloroquine, and aspiration are treatments for liver abscess. Careful sanitation and use of peeled foods and bottled water are preventive.
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PMID:Common intestinal parasites. 1502 17

Trichotillomania is characterized by recurring hair pulling behavior and repeated attempts to decrease or stop the behavior. This behavior can cause a trichobezoar, which is a mass of hair found in the stomach. Patients with diagnosed celiac disease may have an urge to swallow their hair due to iron or folat deficiency, which is called pica. We report a case of an 11-year old girl with celiac disease who has had trichotillomania for a duration of 2 years, and required an operation due to residual gastric hair mass. In this case trichotillomania was more likely caused by behavioral disorders secondary to celiac disease, rather than the iron deficiency due to malabsorption.
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PMID:Trichotillomania in celiac disease patient refractory to iron replacement. 2877 66