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

A case of Whipple's disease in a female is described. Malabsorption of iron, vitamin B12, folic acid and fat was present. These abnormalities reverted to normal after introduction of co-trimoxazole therapy. The patient's humoral immune system was normal, in contrast to impairment of cell-mediated immunity, which has not improved in spite of co-trimoxazole treatment for 2 years, and a therapeutic trial of levamisole. These findings are further evidence that there may be a primary immune deficiency in patients with Whipple's disease.
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PMID:Whipple's disease in a female with impaired cell-mediated immunity unresponsive to co-trimoxazole and levamisole therapy. 7 42

alpha CD is an immunoproliferative disorder which is most frequently, but not always, associated with the disease entity referred to as Mediterranean lymphoma with malabsorption. In most cases, the evolution of the disease and its morbid anatomy suggests an immune deficiency state in which an abnormal clone of intestinal plasma cells incapable of producing the complete IgA molecule proliferates, perhaps in response to microbial antigenic stimulation. In the majority of cases, this proliferation is composed of mature appearing plasma cells which lack morphologic features of malignancy. Although possibly reversible, this proliferation appears to be highly susceptible to the evolution of secondary neoplastic clones, which appear in most instances after a clinical course of unpredictable duration and manifest themselves in the form of single or multiple immunoblastic sarcomas.
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PMID:The pathologic anatomy of alpha chain disease. 82 78

A 46-year-old man with nontropical sprue had anemia and hypoproteinemia for several years, until his condition was diagnosed and treated with dietary measures. Within a year after the diagnosis, progressive multifocal leukoencephalopathy developed, and the patient had a slightly fluctuating chronic downhill course until he died 10 years later. It is postulated that this patient's immune deficiency was related to his malabsorption syndrome and hypoglobulinemia, and the course became unusually protracted (longest reported course in the American literature) because of restoration of plasma protein levels. Autopsy showed the classic findings of progressive multifocal leukoencephalopathy, with much tissue loss of subcortical white matter and active perivascular inflammatory foci with numerous eosinophilic granulocytes. On electron microscopy, oligodendrocyte nuclei and cytoplasm were crowded with virions, but many myelin sheaths invested by severely infected oligodendrocytic processes were remarkably well preserved. This fact would argue against a direct cause-and-effect relationship between infection of oligodendrocytes and myelin breakdown in progressive multifocal leukoencephalopathy. The likelihood of an autoimmune mechanism at work in this disease is suggested, and the role of eosinophils and other cells in such process is considered.
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PMID:Progressive multifocal leukoencephalopathy with 10-year survival in a patient with nontropical sprue. Report of a case with unusual light and electron microscopic features. 123 16

Menetrier's disease in infancy is extremely rare, and its natural course has not been studied in detail. The present case report describes an infant whose initial diagnosis was formula protein allergy and who developed gastric outlet obstruction by 3 months of age. The diagnosis of Menetrier's disease was suggested by characteristic radiological, pathological, and functional abnormalities of the stomach. Small intestinal partial villous atrophy, malabsorption, and protein loss from both the stomach and the intestine were documented. Cytomegalovirus infection was excluded. There was no evidence for an immune deficiency. The described features and an unrelenting course suggest that infantile Menetrier's disease may be an entity distinct from the childhood and adult forms.
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PMID:Menetrier's disease associated with formula protein allergy and small intestinal injury in an infant. 142 87

In two white adults born, raised, and living in central France and presenting with long-lasting malabsorption, massive and diffuse lymphoid infiltrate of the lamina propria associated with crypt scarcity was found along the whole small bowel. It was mostly composed of mature lymphocytes, focally mixed with plasma cells and reactive germinal centers. There was no evidence of celiac disease, systemic or intestinal immune deficiency or alpha-chain disease, overt lymphoid malignancy, or stagnant-loop syndrome. By immunofluorescence the infiltrate was constituted in 1 case of polyclonal B cells and, in the other, of a large majority of T11, T8, T10, and class II-positive T cells associated with a population of monotypic B cells. A gluten-free diet and parenteral nutrition proved ineffective. A dramatic and protracted clinical response was observed in both patients after the onset of oral tetracycline therapy, and still persists after 8 and 5.5 yr, respectively, together with morphologically unchanged small bowel infiltrate. These cases may be the equivalents, in people from Western developed countries, of the predominantly lymphocytic variety of the immunoproliferative small intestinal disease described in people from developing countries.
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PMID:Diffuse small intestinal lymphoid infiltration in nonimmunodeficient adults from Western Europe. 274 69

We report the case of a 22-year old unmarried woman who presented with selective IgA immune deficiency, moderate intestinal malabsorption syndrome with pseudo-atrophy of the villi, and mixed connective tissue disease. Although immune deficiency and malabsorption syndrome are frequently associated, association with an autoimmune disease is rare and we were unable to find any case of association with a connective tissue disease in the literature.
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PMID:[Selective immune deficiency in IgA. Intestinal malabsorption syndrome and mixed connective tissue disease]. 361 41

A child with acquired immune deficiency syndrome became severely malnourished presumably as a result of multiple gastrointestinal infections, with numerous organisms including campylobacter, giardia, and cryptosporidium. These opportunistic infections preceded laboratory evidence of immune deficiency. Despite severe diarrhea and marked weight loss, there was no laboratory evidence of significant malabsorption. By using nasogastric feedings, we were successful in promoting a 60% weight gain, and a rise in serum albumin from 1.2 to 4.3 g/dl. While eventual outcome was not altered, this particular patient's clinical course was improved. We suggest that malnutrition should not be accepted as inevitable and that malabsorption should not be assumed in similar acquired immune deficiency syndrome patients. Appropriate studies for malabsorption should be done, and high caloric enteral feedings should be used whenever feasible.
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PMID:Atypical presentation of childhood acquired immune deficiency syndrome mimicking Crohn's disease: nutritional considerations and management. 392 Sep

An evaluation of total hemolytic complement activity (CH100) after fasting or intestinal bypass was performed in rats. The experiment lasted 6 days. Three groups, of 5 animals each, were studied. On the 1st day, basal values of total complement (TC), albumin and body weight were determined. Group A received normal, ad libitum feeding, group B started on a 'water only' diet, group C underwent intestinal bypass. On the 4th and 6th day the parameters were assessed. TC mean values were significantly lower in groups B and C, as compared to group A, on the 4th as well as on the 6th day (p less than 0.01 by Mann-Whitney's U test). Body weight showed a similar trend. Differences in albumin were never statistically significant. Limitations of the analytical method are discussed. The data show that fasting or bypass-induced malabsorption may determine an early decrease in total hemolytic complement activity, though a development of an immune deficiency is not proved.
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PMID:Early decrease in total hemolytic complement activity (CH100) after fasting or intestinal bypass in the rat. 394 40

An 18-year follow-up of a young woman who presented at the age of 10 years with a malabsorption syndrome and recurrent chest infections is reported. The serum immunoglobulins, and in particular the IgA, were increased, cell-mediated immunity was impaired but free alpha heavy chains were not detected. A jejunal biopsy showed plasma cell infiltration of the bowel with villous atrophy. Bronchiectasis, recurrent skin infections, and sinusitis were treated with frequent courses of antibiotics and corticosteroids. An initial presumptive diagnosis of cystic fibrosis was excluded by a normal sweat test. Although difficult to classify her exact type of immune deficiency state, the data would appear to conform to the syndrome of cellular immunodeficiency with normal or near normal immunoglobulins and lymphopenia (Nezelof's syndrome).
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PMID:Plasma cell infiltration of the small intestine, recurrent pulmonary infections, and cellular immunodeficiency (Nezelof's syndrome). 405 Jul 63

Malnutrition is common in human immunodeficiency virus (HIV) infection and plays an important role in morbidity and mortality. Malnutrition can affect hospitalizations, disease complications, quality of life, and survival, and has adverse clinical consequences that may be independent of CD4 lymphocyte count. There have been recent advances in knowledge concerning the pathogenesis of malnutrition and the nature of weight loss in HIV patients. The onset of body cell mass depletion may occur early in the infection and predate significant immune deficiency, implying that the virus itself may be involved. Hypogonadism, a common finding in HIV patients, is associated with body composition changes and is involved in body cell mass depletion. In addition, intestinal dysfunction and malabsorption contribute to weight loss in HIV patients. Several studies have evaluated the use of appetite stimulants, enteral and parenteral nutritional support, anabolic agents, and other agents in the management of weight loss and malnutrition in HIV patients. Results of a randomized trial comparing total parenteral nutrition (TPN) and an oral semi-elemental diet (SED) in AIDS patients with malabsorption indicate that the TPN group consumed more calories and gained more weight than the SED group, but the gain was due to increased body fat. The effect of nutritional support on malnutrition and weight loss in HIV patients and potential secondary benefits to quality of life, physical and mental performance, immune function, and disease progression require further study.
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PMID:Management of nutritional alterations and issues concerning quality of life. 938 9


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