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 study of 60 patients with oro-facial granulomatosis has been conducted and the clinical presentation of this disorder defined. It encompasses the previously recognised clinical entities of Melkersson-Rosenthal syndrome and cheilitis granulomatosa. The pathological features of the disease are lymphoedema and the presence of multiple non-caseating giant cell granulomata. These granulomata are histologically indistinguishable from those found in both gastrointestinal Crohn's disease and systemic sarcoidosis. Within this series of patients, nine had evidence suggestive of gastrointestinal Crohn's disease, and in six this was confirmed. A diagnosis of sarcoidosis was made in a further two patients. The relationship of oro-facial granulomatosis to these systemic granulomatous diseases is not yet clear. Patients with oro-facial granulomatosis who have gastrointestinal symptoms should be investigated for the presence of gastrointestinal Crohn's disease. Those without symptoms should be investigated for evidence of malabsorption or serological evidence of Crohn's disease. Within the present study, the erythrocyte sedimentation rate, full blood count, corrected whole blood folate, serum albumin and calcium were the most sensitive markers of gastrointestinal involvement. Sarcoidosis should be considered in all patients with oro-facial granulomatosis. The absence of clinical signs suggestive of sarcoidosis, a normal chest radiograph and normal levels of serum angiotensin-converting enzyme makes sarcoidosis unlikely.
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PMID:Oro-facial granulomatosis--a clinical and pathological analysis. 397 43

Patients with acquired immunodeficiency syndrome (AIDS) frequently have diarrhea and weight loss. We prospectively examined the upper and lower gastrointestinal tracts in 22 AIDS patients, although severe medical problems often precluded full evaluation. Ninety-six percent (21 of 22) lost weight, and 55% (12 of 22) had diarrhea. The mean (+/- SD) weight loss was 34 +/- 19 lb. Steatorrhea was found in 4 of 14 patients, and D-xylose tests were abnormal in 8 of 14 patients. Mean serum albumin was 3.3 +/- 0.8 g/dl. A significantly diminished plasma selenium level, which can influence immune function, was noted in these AIDS patients. Gastrointestinal infections were identified in 45% of patients. Although diarrhea and malabsorption were more common in the infected group, weight loss and albumin were similar in those with and without demonstrated infections. Flexible sigmoidoscopy showed that of 15 patients, there were two with Kaposi's sarcoma, 10 normals, and three with nonspecific endoscopic changes of colitis. Infection was documented in all patients with colitis. Panendoscopy of the upper gastrointestinal tract was positive for AIDS-related pathology in five of 10 patients, including two with Kaposi's sarcoma, one with Candida esophagitis, one with herpetic esophagitis, and one with gastroduodenitis (biopsy positive for cryptosporidia); five patients had a normal-appearing tract. Small bowel or colonic biopsies frequently showed nonspecific inflammatory changes, although pathogens were identified in six patients (27% of all biopsies). We conclude that a wide variety of gastrointestinal pathology, which includes infectious agents, neoplasms, and inflammatory changes, may occur in AIDS patients. Therefore, AIDS patients, particularly those with diarrhea or weight loss, deserve an intensive evaluation for remediable lesions of their gastrointestinal tracts.
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PMID:Gastrointestinal manifestations of the acquired immunodeficiency syndrome: a review of 22 cases. 404 Nov 33

Using a double-lumen tube perfusion system, solutions of glucose (1.0, 2.5, and 5.0 g 100ml(-1)) have been perfused into the upper jejunum of 22 Zambian African subjects in order to study their glucose absorption kinetics. None of them had clinical evidence of malnutrition or intestinal disease. In 10 there was no evidence of an infective disease (;normal' group); seven had tuberculosis; five had acute bacterial infections. The mean serum albumin concentration was significantly lower in those with infections; the mean total and gamma-globulin concentrations were significantly higher in the tuberculosis group. There was good reproducibility in triplicate assessments of glucose and water absorption rates in the individual subjects. Despite a wide scatter, the mean glucose kinetic curves were significantly flatter in those with infections than in the normal group (p<0.02). There was a significant association between glucose and water absorption rates in the individuals. D-xylose absorption was estimated in 11 subjects and there was a significant correlation between that and the glucose absorption rate. Jejunal morphology (n=9) and disaccharidase concentrations (n=6) were normal for African subjects and there were no significant associations between either of those and the absorption rates. Galactose absorption kinetics have been studied in an additional four relatively normal Zambian Africans. This study suggests that systemic bacterial infections can produce malabsorption. This may be relevant to the weight loss in patients with pulmonary tuberculosis and also to the aetiology of kwashiorkor.
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PMID:Glucose absorption kinetics in Zambian African patients with and without systemic bacterial infections. 411 99

Serial blood-xylose concentrations have been determined in 28 Papua New Guineans after 25 g oral xylose; 9 had an acute and 8 a chronic systemic infection, 4 the tropical splenomegaly syndrome and 7 were free of infection. Mean xylose was significantly depressed at 30, 60, 90 and 120 min in those with acute and chronic infections. Correlations between xylose and serum albumin, alpha 1, alpha 2, beta- and gamma-globulin concentrations were not significant. When the xylose test is used in tropical countries the effect of systemic infections on the result must be careful evaluated, otherwise tropical malabsorption ('tropical sprue') might be diagnosed erroneously.
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PMID:Influence of systemic infections on xylose absorption. 611 56

In order to assess the effectiveness and potential limitations of continuous enteral nutrition (CEN) to correct denutrition related to underlying digestive diseases, 10 nutritional criteria were measured weekly in 92 under-nourished patients fed with CEN for a 3-7 week period. All the patients received a standard non-elemental diet providing a mean daily energy intake of 52.8 kcal/kg BW (36.5 kcal/kg BW by tube feeding and 16.3 kcal/kg BW orally). The influence of preexisting intestinal malabsorption, hypercatabolic status, and post-radiation or inflammatory bowel disease was studied by an a posteriori classification of patients in one of the six following groups: I (no limiting factor), II (malabsorption), III (catabolic disease), IV (catabolic disease and malabsorption), V (colitis), VI (enteritis). During CEN, 8 patients had transient and one had persistent vomiting while 3 developed bronchopneumonia. Gains in body weight, triceps skinfold, midarm muscle circumference, creatinine-height index, urinary sodium and serum transferrin were significant as early as the 2nd week of CEN. Serum albumin and cholesterol, hemoglobin, and total count of lymphocytes were not significantly affected. Sixty-five patients (71 per cent) had an objective nutritional improvement and mean spontaneous oral intake increased from 17.8 to 28.7 kcal/kg BW per day. Significant increase of oral intake and objective nutritional improvement were observed in each group, but a longer period of CEN was necessary to achieve this result in groups II, IV and VI.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Does continuous enteral nutritional deficiencies in digestive system diseases? Results of a longitudinal study of 92 consecutive patients treated for 3 to 7 weeks]. 642 Feb 21

To explore the effect of the acquired immunodeficiency syndrome on gastrointestinal structure and absorption, the cases of 12 homosexual men with the syndrome and 11 homosexual controls were studied. Seven patients had diarrhea with weight loss. Bacterial or parasitic infections were not detected. All patients were malnourished; had significantly fewer T-lymphocyte helper and suppressor cells; and had significantly lower body weights, midarm circumferences, serum albumin concentrations, and iron binding capacities than homosexual controls. D-Xylose malabsorption and steatorrhea were present in patients, especially those with diarrhea. Jejunal and rectal biopsy samples were histologically abnormal in all patients with diarrhea. Jejunal abnormalities included partial villus atrophy with crypt hyperplasia and increased numbers of intraepithelial lymphocytes. Rectal abnormalities included intranuclear viral inclusions, mast cell infiltration in the lamina propria, and focal cell degeneration near the crypt base. The histologic findings suggest that a specific pathologic process occurs in the lamina propria of the small intestine and colon in some patients with the syndrome.
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PMID:Enteropathy associated with the acquired immunodeficiency syndrome. 647 31

A survey of vitamin D status in 152 patients with chronic gastrointestinal conditions and 104 patients with chronic liver diseases is presented. Mild deficiency was common and severe deficiency, as judged by plasma 25-OHD levels less than 8 nmol/l, was encountered in every disease category tested. In the gastrointestinal disease patients, deficiency was significantly more common in patients following gastroenterostomy than other gastric surgery, in patients with active Crohn's disease than in those with inactive disease and in patients with chronic pancreatitis or pancreatic carcinoma with cholestatic features than in those without cholestatic features. Deficiency was as common in patients with Crohn's disease who had not been treated surgically as in those who had. There was no significant correlation between plasma 25-OHD levels and any laboratory index of malabsorption or malnutrition except for serum albumin in the gastric surgery patients, haemoglobin and ESR in the Crohn's disease patients and albumin and vitamin E in the group of patients with gastrointestinal disorders taken as a whole. In the chronic liver disease patients, those with late primary biliary cirrhosis had lower plasma 25-OHD levels than those with histological Stage I and II disease who all had normal levels, and those with pruritus and jaundice were more commonly severely deficient. Whatever the underlying disease process, patients with other coincidental medical conditions were much more likely to be deficient as were patients with cholestasis. Evidence of secondary hyperparathyroidism and osteomalacia on bone histology indicated the clinical relevance of the vitamin D deficiency. This study showed no relationship between abnormal plasma vitamin D binding protein levels and vitamin deficiency.
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PMID:A survey of vitamin D deficiency in gastrointestinal and liver disorders. 654

The effect of intestinal malabsorption on the oral bioavailability of prednisolone has been studied in six patients with celiac disease and in six patients with malabsorption of various etiologies, five of whom had undergone gut resections. The serum protein-binding of prednisolone was measured in five patients with celiac disease and hypoalbuminemia and in eight healthy controls. Compared with the controls, patients with celiac disease had a 22% lower peak serum prednisolone concentration (p less than 0.05) and a 16% smaller area under the time-concentration curve of total prednisolone (NS). The proportion of free prednisolone was 79% greater in patients with celiac disease (p less than 0.01), and the area under the time-concentration curve of free, biologically active prednisolone 53% larger (p less than 0.05). There were no significant differences in peak prednisolone concentration or area under the time-concentration curve between the controls and the other patients with malabsorption, who all had normal serum albumin concentrations. These results indicate that the absorption of prednisolone in patients with malabsorption is normal and that the apparently reduced bioavailability in celiac disease patients is more likely to be due to an increased volume of distribution secondary to hypoalbuminemia and reduced protein-binding.
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PMID:Bioavailability of prednisolone in patients with intestinal malabsorption: the importance of measuring serum protein-binding. 666 30

Hydrogen and methane in human breath derive entirely from bacterial fermentation in the intestinal lumen. The sources of substrates utilized for these reactions have not been completely determined. Basal excretion of both gases occurs in the fasted state, while malabsorbed carbohydrate commonly results in increased hydrogen but not methane production. Using an in vitro fecal incubation system, we have studied hydrogen and methane production from glycoproteins of endogenous as well as dietary origin. All glycoproteins tested yielded hydrogen when incubated with fecal homogenates. Mean hydrogen production from substrates containing less than 3% sugar (human serum albumin, bovine serum albumin, and alpha-casein) averaged 2.2 +/- 0.9% of hydrogen production from equivalent amounts of glucose, while carbohydrate-rich mucin yielded 46.0 +/- 6.7% of hydrogen production from glucose. Glycoproteins of intermediate carbohydrate content, including transferrin and egg white, yielded intermediate values. Methane production from glycoproteins was optimal from carbohydrate-poor protein substrates in fecal homogenates which accumulated hydrogen and became rapidly acidic when incubated with pure carbohydrate. In contrast, methane production was comparable for essentially sugar-free proteins, glycoproteins, and glucose when hydrogen did not accumulate and neutral pH was maintained. We conclude that glycoproteins are substrates for hydrogen and methane production by colonic bacteria from healthy adults. In individuals with bacterial overgrowth syndromes and in protein-losing enteropathy, bacterial catabolism of endogenous glycoproteins may cause increased basal hydrogen and methane excretion. These findings also raise the possibility that measurement of hydrogen or methane after oral administration of dietary glycoproteins may be useful in detection of protein malabsorption.
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PMID:Glycoproteins as substrates for production of hydrogen and methane by colonic bacterial flora. 708 16

The relationship of the serum iron-binding capacity (IBC) to the serum proteins and other haematological parameters was studied in 96 elderly subjects. With two exceptions, IBC levels above the normal range were confined to cases of anaemia with transferrin saturation levels of less than 12%. In 13 cases the IBC was below normal, and in 9 it was normal in the presence of iron deficiency; in these groups the IBC correlated with serum albumin, and there was a clinical explanation for protein depletion. In cases with normal serum albumin and normal transferrin saturation, there was no decline in IBC with age. The best serological index of iron status was the transferrin saturation, which was less than 12% in significant iron deficiency. Malabsorption of inorganic iron was demonstrated in 11 out of 30 iron-deficient patients, 4 of whom had reduced IBC, but there was no relationship between iron absorption and the IBC.
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PMID:Factors affecting the serum iron-binding capacity in the elderly. 708 78


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