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)

Patients with extensive small-bowel resection may experience malabsorption and nutrient deficiencies. We evaluated the ability to absorb fat and fat-soluble vitamins in a short-gut patient. For 18 wk after stopping intravenous lipid, while consuming a low-lactose, low-fat diet, he exhibited no clinical manifestations of essential fatty acid deficiency (EFAD). Serum 20:4n-6 (20:4 omega-6) and 18:2n-6 fatty acid concentrations were normal, whereas the concentration of 20:3n-9 remained less than or equal to 0.1% of total serum fatty acids. Although serum vitamin A was normal, beta-carotene was undetectable despite oral supplementation. Prothrombin time was elevated until parenteral vitamin K was given. This patient has fat absorption adequate to prevent EFAD but inadequate absorption of fat-soluble vitamins. In patients with short bowel, the requirements for parenteral lipids and fat-soluble vitamins should be determined independently.
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PMID:Essential fatty acid sufficiency does not preclude fat-soluble-vitamin deficiency in short-bowel syndrome. 198 17

The present study was undertaken in view of the higher incidence of thromboembolism in patients with Crohn's disease. The blood coagulation system was studied in 12 patients previously operated for Crohn's disease (8 cases of ileitis, 4 cases of colitis) and followed as out-patients. In 75% of cases, the disease was in an inactive stage. Eight patients showed slight lipid malabsorption. Serum levels of fibrinogen, platelets and factor V were shown to be significantly increased (p less than 0.001) as compared to controls. Prothrombin time and factors II, VII and X were shown to be decreased, while factors VIII and IX and antithrombin III were not significantly altered. Thrombocytosis and hyperfibrinogenemia, as reported in literature, seem to determine a condition of blood hypercoagulability, playing therefore a primary pathogenetic role in the genesis of thromboembolism in patients with Crohn's disease.
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PMID:Blood coagulation alterations and thromboembolism in Crohn's disease. 664 10

Coeliac disease is usually revealed by intestinal symptoms, but less frequently by deficiency symptoms. Early screening is very important to avoid with appropriate diet an intestinal lymphoma or epidermoid cancer. We report here the case of a 68-year old woman where coeliac disease was pointed out by very long Prothrombin Time (PT) and Activated Partial Thromboplastin Time (APTT). Clinical examination was strictly normal except for leanness, a small height, and several diarrhoea episodes 3 or 4 times a year. Other blood tests showed a macrocytic anemia, a fibrinogen level slightly above the upper limit, a decreased proteinaemia and albuminaemia, and a sideraemia at the lower normal limit. Liver tests pointed to a cytolysis. Vitamin K-dependent factors were decreased. A perfusion of vitamin-K allowed getting a normal PT. Duodenofiberscopy with biopsy allowed the diagnosis of coeliac disease. Neither lymphoma nor epidermoid cancer were detected. A gluten-free diet allowed the disappearing of digestive symptoms, weight rising and return to a normal PT. Searching for a coeliac disease is therefore relevant in aged patients even when very faint clinical or biological symptoms of malabsorption appear, particularly when PT is longer than the control with decreased vitamin-K dependant factors.
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PMID:[A case of celiac disease with late diagnosis by very long prothrombin and activated partial prothrombin times]. 1535 14

This study examined the prevalence of vitamin K deficiency in children pre-bone marrow transplantation (BMT). Vitamin K status was measured by the PIVKA-II assay and prothrombin times. Blood samples were obtained before vitamin-containing TPN was infused. Results indicated that eight of 26 patients (31%) were vitamin K deficient; four cases were attributed to drug antagonism (phenytoin) and four were due to inadequate vitamin K intake, synthesis or malabsorption. Only one patient had a prolonged prothrombin time. Prothrombin time, in our study, is shown to be an ineffective screening tool to determine vitamin K status. All patients receiving phenytoin and chemotherapy are at increased risk of vitamin K deficiency.
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PMID:Vitamin K deficiency in children pre-bone marrow transplantation. 1628 12

A 53 year old female who was maintained on long-term warfarin therapy due to history of pulmonary embolism, repeatedly presents with an abnormally prolonged Prothrombin Time (PT) and Activated Partial Thromboplastin Time (APTT). After many asymptomatic episodes were corrected with Vitamin K therapy to temporarily reverse the effects of the warfarin, the cause of the apparent coagulopathy was further investigated. Factor Activity Assays of the common pathway factors II, IX, and X all revealed critically low values; below the threshold even a loading dose of warfarin is typically capable of eliciting. The patient tested strongly positive for Tissue Transglutaminase IgA, which is highly suggestive of a gluten-sensitive enteropathy. One effect of this condition is malabsorption due to flattened intestinal villi. The patient was determined to have an acquired vitamin K deficiency secondary to gluten-sensitive enteropathy. Her condition was exacerbated by the long-term warfarin therapy, resulting in the prolonged PT and PTT. The patient was treated with vitamin K therapy, which reversed the deficiency and corrected her abnormal coagulation results.
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PMID:Warfarin hypersensitivity due to gluten-sensitive enteropathy: a case study. 2269 76