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

A 59 year old woman with insulin-dependent diabetes mellitus and chronic diarrhea was found to have mild steatorrhea, selective plasma IgA deficiency and adrenal insufficiency. Significant adrenal secretion of corticosteroids resulted only after prolonged stimulation with large doses of exogenous ACTH. Plasma ACTH levels were not elevated during clinical adrenal insufficiency or after metyrapone administration but did respond normally to vasopressin and insulin-induced hypoglycemia. These studies were interpreted as showing both primary adrenal insufficiency and impaired pituitary reserve for ACTH secretion in response to the feedback stimulus. No deficiency was found in secretion of other pituitary tropic hormones. Jejunal biopsy showed a lack of IgA-containing plasma cells. With cortisone replacement, diarrhea subsided and a malabsorption pattern on a film of the small bowel was no longer seen. IgA deficiency has been noted frequently with steatorrhea but rarely with diabetes and only once previously with adrenal insufficiency.
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PMID:Atypical adrenal insufficiency with failure of the pituitary feedback receptor. A case with associated diabetes mellitus and selective IgA deficiency with steatorrhea. 17 48

Three persons in a kindred of 43 had variable expression of a syndrome consisting of immunoglobulin A deficiency, diabetes mellitus, malabsorption, and a common HLA haplotype. Findings from the proband included life-threatening malabsorption; idiopathic intestinal mucosal atrophy with infalmmation; IgA deficiency and antibodies to multiple endocrine organs; insulin-dependent diabetes mellitus; and the major histocomptability antigens HLA-A2, B8, and DW3. In addition to the described syndrome other conditions present in the family include Graves' disease, vitiligo, hypocomplementemia, rheumatic fever, multiple sclerosis, and a high frequency of antibodies to endocrine tissue. Since Graves' disease, diabetes mellitus, and idiopathic Addison's disease have all been described in association with HLS-B8 and DW3, we believe that the occurrence of these diseases in this family suggests that a single immune response gene or gene complex is linked with HLA-B8 and DW3.
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PMID:A syndrome of immunoglobulin A deficiency, diabetes mellitus, malabsorption, a common HLA haplotype. Immunologic and genetic studies of forty-three family members. 57 75

Since kappa-chain deficiency is an unusual condition, we studied the clinical and laboratory findings in a patient with this deficiency. The patient had cystic fibrosis with concurrent malabsorption, diabetes mellitus and IgA deficiency. The serum levels of IgM and IgG were 0.85 and 7.22 mg per milliliter, respectively. Kappa type IgM and IgG was not present in serum and external secretions; gamma, mu and lambda chains were probably polyclonal in character. Antibodies against kappa chains were not detected in either the patient or the mother. Plasma cells containing kappa-type immunoglobulins were absent in jejunum samples and bone marrow; kappa-chainbearing B lymphocytes could not be detected in blood and bone marrow. The serum of one of the patient's sisters contained trace amounts of kappa-type immunoglobulins. The patient displays a complete absence of kappa-type immunoglobulins, probably owing to a genetic defect.
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PMID:Kappa-chain deficiency. An immunoglobulin disorder. 81 19

Two IgA-deficient children with inflammatory myopathy and intestinal malabsorption were evaluated. The myopathy was characterized by weakness of facial and proximal limb muscles, increased serum concentrations of lactic dehydrogenase and creatine phosphokinase, and histologic evidence of inflammation and degeneration of muscle fibers. Features of the intestinal abnormality were blunted villi, interstitial inflammation, and reduction in IgA-containing plasma cells and IgA content of epithelial cells. The myopathy and malabsorption improved with corticosteroid treatment. Circulating antibodies to striated muscle could not be demonstrated in either patient, but one had antibodies to milk and chicken serum proteins. We speculate that IgA deficiency may predispose to the development of inflammatory myopathy.
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PMID:Inflammatory myopathy, IgA deficiency, and intestinal malabsorption. 94 14

Giardia lamblia infestation can cause severe diarrhea and malabsorption, and the diagnosis is usually made by identification of cysts in the feces, but small intestinal biopsy or smears may be required. A wide spectrum of roentgen changes may be seen. In patients with a normal immune status, the small bowel is normal or shows an inflammatory bowel disease pattern. Eradication of the parasite reverses these changes. In some patients with IgA deficiency, nodular lymphoid hyperplasia occurs, and this is usually not reversible. Other patients with hypogammaglobulinemia or dysgammaglobulinemia and giardiasis may show a sprue pattern. This pattern most often persists after eradication of the parasite. Although the triad of giardiasis, IgA deficiency, and nodular lymphoid hyperplasia has a particularly high association, these, together with diarrhea, malabsorption, and various altered immune states may occur in any combination.
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PMID:Current perspectives on giardiasis. 110 21

The case of a 59 year old white man who had chronic malabsorption and selective IgA deficiency with severe iron deficiency is reported. In addition, he was deficient in vitamin E and selenium, important antioxidants which protect against lipid peroxidation. He was intolerant of oral iron and when treated with iron-dextran developed symptoms suggestive of polymyositis with evidence of rhabdomyolysis. It is suggested that free iron within iron-dextran activated free radicals, initiating lipid peroxidation and leading to polymyositis, rhabdomyolysis, and myoglobulinuria.
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PMID:Rhabdomyolysis after intramuscular iron-dextran in malabsorption. 201 14

Among 10 children with giardiasis, eight had iron deficiency; iron deficiency anemia was the main complaint in three. Evaluation of iron absorption by the oral iron load test demonstrated a subnormal response (i.e., increase in serum iron levels of less than 100 micrograms/dl) in all eight patients with iron deficiency. In contrast, in two iron-sufficient patients with giardiasis the response to an oral iron load was normal. Xylose absorption was abnormal in five of the 10 patients. After metronidazole dosing, iron absorption became normal in seven patients but remained abnormal in one patient, who also had IgA deficiency. Xylose absorption became normal in all five patients who underwent a second test, but remained abnormal in the patient with IgA deficiency. Concomitant morphologic-studies of jejunal biopsy material from these patients revealed moderate changes in the intestinal mucosa of two patients. We conclude that malabsorption of iron is a complication of giardiasis.
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PMID:Iron malabsorption in giardiasis. 400 42

Eight adults presenting with giardiasis to a gastrointestinal unit during a two year period were studied in detail. Symptoms were varied, diarrhoea occurring in only five patients. Four of the eight gave a history of travel to endemic zones, and three of those who gave no such history had possible predisposing conditions (gastric surgery (2), and borderline IgA deficiency (1]. Most patients exhibited mild malabsorption of fat and vitamin B12, and some abnormality of jejunal disaccharidases was usual. Jejunal histology varied from normal to partial villous atrophy, and the intraepithelial lymphocyte count was raised in those patients with the most marked histological abnormality. Treatment with metronidazole was uniformly successful, and most of the above abnormalities reverted to normal within a month of treatment.
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PMID:Clinical studies in adults presenting with giardiasis to a gastro-intestinal unit. 401 71

23 patients with gastroenteritis and 9 with severe malabsorption syndrome related to giardiasis were investigated in a semi-prospective fashion as follows: (1) conjugated bile acid levels measured in duodenal aspirate (thin layer chromatography) in 6 patients with steatorrhea. (2) intraepithelial lymphocytes count (results expressed as the number of intraepithelial lymphocytes per 100 epithelial cells) in small intestinal biopsies from the 32 patients, 11 of which had immunoglobulin deficiency (9 IgA deficiency). The results indicate that there is no decrease in the percentage of conjugated bile acids (mean percentage 90%; normal = 80); a significantly increased percentage of intra-epithelial lymphocytes is documented in giardiasis (11.1% +/- 6.7), versus 2.3% +/- 0.5 in acute gastroenteritis (9 patients) and 6.3 +/- 0.5 in chronic diarrheas (6 patients) (p less than 0,001). This percentage, however, is significantly lower than in untreated coeliac sprue (23 patients) (12.17 +/- 11.6) (p less than 0,01). Conversely a high intraepithelial lymphocyte count does not correlate with the degree of intestinal villous atrophy (3 patients had severe and 6 partial villous atrophy) (r = 0.170). IgA deficiency should be suspected in patients with giardiasis presenting with intestinal villous atrophy (5 patients). Steatorrhea in our patients does not appear related to bile acid deconjugation. To explain enterotoxicity in giardiasis, more than a direct effect of the ventral disk of the parasite on intestinal mucosa, one should incriminate the host immune cell mediated response as shown by lymphocytic infiltration of the epithelium on small bowel biopsies.
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PMID:[Enteropathogenic mechanisms involved in giardiasis in children (author's transl)]. 710 70

Selective serum IgA deficiency and follicular lymphatic hyperplasia of the terminal ileum were observed in a 30-year-old patient. Due to the relative ileal stenosis he complained of colicky abdominal pains particularly after flatulant food. There was no malabsorption syndrome or lambliasis. Although immunohistochemically IgA producing plasma cells were demonstrated in the intestinal wall, no immunoglobulin could be demonstrated in the intestinal juice, suggesting a secretory defect. The very high percentage of IgE producing plasma cells was noteworthy, these cells having led to the macroscopical picture of follicular hyperplasia. Due to the relative frequency of IgA deficiency (about 1 : 700) and the known increased incidence of malignant disease regular surveillance of these patients is indicated.
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PMID:[Follicular lymphatic hyperplasia of the small intestine in antibody deficiency syndrome (author's transl)]. 723 22


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