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

A 10-year-old mentally retarded girl was sent to our hospital due to generalized edema, vomiting and poor appetite for several days. Serum albumin level was low, but no proteinuria was detected. Her stool was bulky and foul. Stool examination for parasite with formalin-ether concentration method revealed negative result. Trypsin activity test of stool revealed low trypsin activity as compared with normal specimen. Daily fecal fat exceeded upper normal limit. The diagnosis of giardiasis was confirmed by duodenal juice examination. Intestinal histology revealed mild shortening of the villi with increased mononuclear cell infiltration in the lamina propria. The daily stool amount decreased markedly after treatment with metronidazole 250 mg three times a day for 7 days. The edema subsided during the treatment. Serum albumin bevel returned to normal after the treatment. Giardiasis with malabsorption syndrome has often been overlooked in Taiwan. It is advised that in case of malabsorption syndrome giardiasis should be included in the list of differential diagnosis.
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PMID:[Giardiasis with malabsorption syndrome: report of one case]. 227 67

Diarrhea affects approximately 330,000 travelers from industrialized nations each year. Diarrhea is a reflection of inadequate hygiene or waste disposal in the countries visited, usually developing countries. The greatest incidence occurs in 20-29 years olds who take the most dietary risks. Some foods that pose the greatest risk in descending order include raw oysters, steak tartare, ice cubes, washed vegetables, cold milk, puddings, and sandwiches with mixed fillings. 40% of all travelers have a self limiting and rarely grave diarrheal illness caused by local enterotoxigenic Escherichia coli (ETEC). Following an incubation period of 5-9 days, symptoms appear (cramps, fever, and 10 or more diarrheal episodes/day). 5% are infected with Giardia lamblia and 4% with Entamoeba histolytica. Giardiasis occurs worldwide and is characterized by grumbling diarrhea, cramps, and flatulence. E. histolytica causes a severe illness characterized by colitis with bloody stools, anorexia, malaise, sweats, weight loss, and epigastric pain. Only 10-100 Shigella bacteria are required by cause shigellosis. Symptoms include blood and mucus in the diarrhea and malaise. A traveler who ingests food with 100,000 Salmonella bacteria in it most likely will fall ill 48 hours after eating the contaminated food. Typhoid and paratyphoid fevers have an incubation period of about 12 days and may be fatal. Initial symptoms consists of headache, malaise, fever, and pain and 2 weeks later bloody diarrhea appears. Additional common diarrheal illnesses include cholera, post infectious tropical malabsorption, and those caused by Vibrio parahaemolyticus and Campylobacter species. Another disease common in areas of poor hygiene is poliomyelitis with fever, sore throat, and headache present in mild forms. If the virus invades the central nervous system, however, paralysis occurs.
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PMID:Exotic diarrhoeal problems and poliomyelitis. 259 59

Comparative studies of body weight, height, intracellular water representing cell mass, and age, and plasma concentrations of albumin, vitamins, trace elements and iron stores in Aboriginal children aged 6 to 13.5 years, from two rural Aboriginal settlements and one rural Caucasian school (Hawker) provided evidence of significant deficits in one of the Aboriginal settlements (Yalata). Yalata Aboriginal children had lower body weights and heights for age and lower intracellular water values. Plasma albumin, zinc, iron, alpha-tocopherol, beta-carotene and retinol concentrations were lower relative to the normally grown Aboriginal children at Nepabunna. The latter children did not differ from rural Caucasian children for the parameters studied. The reasons for this poorer growth at Yalata may reside in poor nutrition, or repeated bowel infection in postnatal life leading to malabsorption, or both. Limited observational evidence suggests that Giardiasis has a high prevalence at Yalata, and it has been shown elsewhere that Giardiasis is capable of inducing malabsorption with resulting nutritional deficiencies.
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PMID:Malnutrition in aboriginal children at Yalata, South Australia. 273 99

10,000 faeces samples-from 9,120 adults and 880 children were examined to evaluate the faecal excretions. Giardia intestinalis was identified in 111 of those samples (84 adults and 27 children). A higher infection rate of G. Intestinalis was observed in child and male adult groups. Nitrogen excretion was evaluated and compared with fat excretion for the first time in the case of giardiasis. When malabsorption was obvious, both fat and nitrogen increased with generally moderate values. The malabsorption was much more frequent among children (88.9%) than among adults (26%) (p less than 0.001). These results could explain the fast settlement and the frequency of growth troubles in childhood. Giardiasis should be systematically and carefully investigated in a malabsorption in the person of a child.
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PMID:[Giardia intestinalis: comparative study of lipid and nitrogen fecal excretions in adults and children with parasites]. 353 27

Giardia lamblia is the first protozoan to be identified and recognized as an important pathogen in human disease. We studied 8 pediatric patients with giardiasis in order to examine the clinical spectrum, the structural changes of the small intestinal mucosa and mainly the protozoan's ultrastructural features. The most common clinical manifestations were diarrhea, abdominal pain, anorexia, vomiting, failure to thrive. Infection was confirmed by excreted cysts in the stools in one patient, by the presence of trophozoites in duodenal aspirate and on jejunal mucosa. Giardiasis was not associated with hypogammaglobulinemia in our patients and no or only slight mucosal abnormalities were present in jejunal biopsies, except one which showed a flat mucosa. Specimens for transmissions and scanning electron microscopy were taken. We could establish the protozoan's features, its normal distribution, its relationship to intestinal mucosa and structural indications of the normal reaction of intestine with the use of ultrastructural techniques. The trophozoites colonized the proximal intestine, adhered to microvilli of columnar cells near the bases of villi, wedged or lodged in mucus. The sticky mucus producing an effective diffusion barrier to nutrients could explain malabsorption phenomena. Numerous intraluminal lymphocytes were seen, suggesting an immune response. These observations indicate that in giardiasis the clinical spectrum and structural changes of the small intestinal mucosa vary widely, suggesting a different reaction of immune system and/or a different degree of infection.
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PMID:[Giardiasis in children. Ultrastructural study of the parasite]. 664 80

Giardiasis is the most common waterborne diarrheal disease in the United States and is highly prevalent throughout the world. The clinical spectrum of disease ranges from asymptomatic infection to persistent severe malabsorption. The precise interaction between Giardia and its human host remains conjectural because of the paucity of published studies that address the details of its pathogenesis. The immune system of the host responds to this protozoan parasite, and the intestinal epithelium is a site of interaction between parasite and host. Possible mechanisms whereby Giardia may alter the host's absorption of nutrients at the epithelial level include direct physical interference, toxin secretion, direct physical alteration of the epithelium, competition for nutrients, induction of an inflammatory response, and coincidental infection of the host with a second organism. The host's immune system may play both a protective and a pathogenic role.
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PMID:Giardiasis: host-pathogen biology. 675 Jul 49

The debate about the pathogenicity of Giardia lamblia in man has ended, and th issues regarding the prevalence of clinical and subclinical infections and their nutritonal impact have become the foremost considerations. Giardiasis can produce steatorrhea, maldigestion, and malabsorption of carbohydrates and of vitamins A and B12. The mechanisms of the absorptive dysfunction are not clear, but morphological abnormalities of the intestinal mucosa and/or bacterial overgrowth might play a role. Severe clinical giardiasis can cause "failure to thrive" in young children, but the impact, if any, of subclinical giardiasis on growth in general populations is not well defined. Protein-energy malnutrition appears to predispose to giardial infection, perhaps because of the accompanying hypochlorhydria, immunosuppression, and altered gastrointestinal flora. The lack of a sensitive and noninvasive diagnostic test for human giardial infection limits the investigation of the nutritional correlates of giardiasis.
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PMID:Giardiasis: nutritional implications. 675 Jul 50

Giardiasis is the most common small intestinal protozoal infection and is found worldwide. The mechanisms by which Giardia duodenalis (= G. lamblia) produces chronic diarrhoea and malabsorption have still not been clearly defined. Many infections are associated with mild to moderate mucosal damage which, in animal models of infection, have functional correlates. Possible mechanisms include direct physical injury, release of parasite products such as proteinases or lectin, and mucosal inflammation associated with T cell activation and cytokine release. Other possible mechanisms of malabsorption include associated bacterial overgrowth and bile salt deconjugation, bile salt uptake by the parasite with depletion of intraluminal bile salts, and inhibition of pancreatic hydrolytic enzymes. Thus, there is no single mechanism to explain the diarrhoea and malabsorption caused by Giardia, which currently should be regarded as a multifactorial process.
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PMID:Diarrhoeal disease: current concepts and future challenges. Pathogenesis of giardiasis. 810 43

Giardiasis is a cosmopolitan parasitosis. Diarrhea, abdominal colic, and flatulence are the main clinical symptoms, however, malabsorption, and impairment of growth of children may occur. The 5-nitroimidazoles are the drugs of choice in the treatment of giardiasis. Methods: The efficacy and tolerability of secnidazole and tinidazole were evaluated in a randomized, open-label, clinical trial performed with 267 Giardia lamblia-positive children. Secnidazole, in a new gel formulation, and tinidazole suspension were prescribed as single oral doses of 30mg/kg and 50mg/kg, respectively. Clinical and parasitological follow-up was carried out before, and at 7, 14, and 21 days after treatment. Results: Clinical cure was observed in 77.3% and 75.7% of the patients in the secnidazole and tinidazole groups, respectively. Parasitological cure was obtained in the 91.3% and 89.6% in the secnidazole and tinidazole groups, respectively. A metallic taste after drug ingestion was more commonly reported in the tinidazole group than in the secnidazole group (p<0.05). Conclusions: The authors conclude that both secnidazole gel and tinidazole administered as a single oral dose are effective treatments for children with giardiasis since both high cure rates and good tolerability were observed.
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PMID:Evaluation of Secnidazole Gel and Tinidazole Suspension in the Treatment of Giardiasis in Children. 1110 44

5000 pediatric patients presenting gastrointestinal disturbance (diarrhoea, vomiting, abdominal pain or stypsis) coming from different urban and rural area of Naples (Italy) were evaluated for possible intestinal Giardiasis at the Department of Pediatrician, University of Naples, Italy. The mean age of the patients was 6.4 years and range 0.5-15 years. Giardia duodenalis was searched in 3 different specimens of stools collected every other day, by a microscopic examination by Stoll method. The presence of Giardia duodenalis was correlated with different parameters: life-style, social environment, social level, season, geographic area and subjective symptoms. Statistical differences in the different groups of patients were evaluated by the chi square test. Giardia duodenalis was found in 237/5000 patients (4.7%) of the patients. In nine of them the protozoa was associated with E. vermicularis and in 8 with T. thichiuria e the highest monthly prevalence was observed in November an December. The most frequent symptom was diarrhoea (61.1%). According to these data the Authors can conclude that Giardiasis is a frequent gastrointestinal infection even in children living in temperate areas. This infection is frequently asymptomatic, but can lead to malabsorption and/or to malnutrition, and can be cause of orticaria.
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PMID:[Giardia duodenalis infections in pediatrics: our series]. 1496 70


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