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)

Two hundred children hospitalized in the National Institute of Gastroenterology were studied during the 1972-1980 period. The children, whose ages ranged between six months and ten years, presented chronic diarrhea in which Giardia lamblia was considered the causative agent. The diagnosis of parasitism was made with the detection of Giardia lamblia in the feces and/or duodenal content. A serum D-Xylose and jejunal biopsy were performed on all the patients and the histology of the mucosa was classified in keeping with the degree of atrophy according to Metayer and Laumonier. In our study we divided the patients into three groups: Group 1, parasitism due to Giardia lamblia in patients with a normal D-xylose and different degrees of atrophy of the jejunal mucosa, but with normal D-Xylose and Group 3, malabsorption due to Giardia lamblia, with a pathological D-Xylose and alterations in the intestinal mucosa. There were 35 cases in Group 1 (17.5%), 91 cases in Group 2 (45.5%) and 74 cases in Group 3 (37%). The predominant intestinal lesion was partial atrophy of the villi (143), 20 with subtotal atrophy of the villi and two with complete atrophy of the villi. It was shown that the host's response to infection by Giardia lamblia varies with differing effects on the structures and functioning of the jejunal mucosa. It is important to group patients with chronic diarrhea due to Giardia lamblia in this way since it allows for and individualized clinical approach and provides a prognosis in terms nutritional consequences resulting from possible persistence of the diarrhea and possible associated lactose intolerance.
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PMID:[A proposal for the classification of intestinal complications in giardiasis]. 357 17

Three tests of small intestinal function were performed at 3100 m and 4846 m to seek evidence of malabsorption of high altitude. Xylose tolerance did not change in 11 subjects but, in three who ascended to 5600 m, one-hour xylose levels were significantly lower. The results of an oxalate loading test did not suggest significant fat malabsorption. A direct fat absorption test using chylomicron levels after ingestion of 100 g fat showed significantly increased levels at high altitude. We conclude that there is no evidence of malabsorption up to 4846 m.
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PMID:Intestinal absorption at high altitude. 367 Dec 55

D-Xylose kinetics were studied after oral and intravenous administration to 10 patients with impaired renal function, three of whom were being evaluated for intestinal malabsorption. The 0.32 +/- 0.06 L/kg (mean +/- SD) distribution volume of D-xylose in patients with uncomplicated renal impairment was larger than the value of 0.23 +/- 0.04 L/kg that we reported previously for normal subjects (P less than 0.01). Renal clearance was also reduced, averaging 87% of glomerular filtration rate estimated from creatinine clearance, so that the elimination-phase half-life was prolonged to 138 +/- 39 minutes from 75 +/- 11 minutes in normal individuals (P less than 0.01). The 25 gm oral D-xylose dose was 77.4% +/- 14.8% absorbed in the patients with uncomplicated renal impairment, similar to the 69.4% +/- 13.6% absorption reported in normal individuals. However, the absorption half-life was prolonged from 31 +/- 12 minutes in normal subjects to a value of 62 +/- 23 minutes (P less than 0.02). Of the usual clinical indexes of D-xylose absorption, the serum concentration measured 1 hour after the oral dose was best correlated with the extent of D-xylose absorption (r = 0.76; P less than 0.01), and the standard lower normal limit of 0.2 mg/ml was satisfactory.
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PMID:D-xylose absorption and disposition in patients with moderately impaired renal function. 381 22

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

Protracted diarrhea is a clinical entity characterized by diarrhea lasting greater than 2 weeks, starting before 3 months of age, with severe nutritional aggravation and negative stool culture for enteropathogens. This report deals with the ultrastructural abnormalities found in the intestinal mucosa of children with protracted diarrhea. Forty children (mean age 5.1 months) were studied. They were submitted to the following tests of intestinal function: D-xylose, triglyceride tolerance, small bowel biopsy (light and electron microscope), sigmoidoscopy, and sweat test. D-Xylose absorption and triglyceride tolerance test in these patients were both significantly lower than controls. Ultrastructural analysis of the small bowel of 12 patients showed various degrees of alterations, mainly shortening of the microvilli, increased number of multivesicular bodies, and vacuolation of mitochondria and endoplasmic reticulum. These lesions were totally reversible after clinical and nutritional recovery as could be proven in two children. The most common cause of protracted diarrhea in these patients was secondary carbohydrate intolerance and dietary protein cow's milk and soy bean intolerance, which resulted in colitis or malabsorption as a consequence of intestinal mucosa injury due to acute gastroenteritis.
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PMID:Protracted diarrhea in infancy: clinical aspects and ultrastructural analysis of the small intestine. 404 29

We evaluated gastrointestinal structure and function in 13 hemizygous males and 17 heterozygous females, five to 67 years old, from four kindreds with Fabry's disease. Gastrointestinal symptoms, noted in 62% (8/13) of the males and 29% (5/17) of the females, were present prior to the diagnosis of Fabry's disease in five patients; were discovered at the time of study in six patients and were associated with multiple other symptoms in two patients. Serum protein, albumin, folate, Vitamin B12, calcium, phosphorous, cholesterol and iron were normal in all 30 patients. Xylose absorption was normal in 2/2 males and 13/13 females studied. HLA B8 antigen was present in none of the males and 2/17 females. Peroral duodenal (one male), jejunal (six males, two females) and rectal (one male) biopsies on light microscopy demonstrated a normal villous pattern and luxol-fast blue positive "foamy" cell deposits in all males, while no deposits were visualized in the females. In all males and females studied, electron microscopic examination showed electron dense, intralysosomal "zebra-like" (0.5-0.75 micrometer.) bodies in the vascular endothelial and perithelial cells and in the cytoplasm of the small unmyelinated neurons, and perineurial cells. Despite the frequency of gastrointestinal symptoms, both malabsorption and celiac disease were absent.
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PMID:Gastrointestinal structure and function in Fabry's disease. 627 88

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

The N-benzoyl-L-tyrosyl-p-aminobenzoic acid (BT-PABA):xylose test was evaluated in 5 clinically normal dogs, 5 dogs with pancreatic exocrine insufficiency (PEI), and 7 dogs with intestinal malabsorption. A solution of BT-PABA (1 g/100 ml) and d-xylose (10 g/100 ml) was given orally (5 ml/kg of body weight) to dogs in each group. Plasma p-aminobenzoic acid (PABA) curves were decreased in dogs with PEI and intestinal malabsorption (P < 0.05) but were the lowest in dogs with PEI, compared with clinically normal dogs. Xylose values in dogs with malabsorption were decreased (P < 0.05), compared with clinically normal dogs. Dogs with PEI had plasma xylose values that were intermediate to values in clinically normal dogs and dogs with intestinal malabsorption. Results of BT-PABA:xylose testing were compared with results of sodium PABA:xylose testing, to determine whether decreased PABA values obtained by the BT-PABA:xylose test were caused by free PABA malabsorption or by maldigestion of BT-PABA. The sodium PABA:xylose test was performed in dogs from each group by oral administration of a solution (5 ml/kg) of sodium PABA (0.372 g/100 ml) and d-xylose (10.0 g/100 ml). Plasma PABA values obtained by the sodium PABA:xylose test were similar in each group. Thus, different PABA values obtained by the BT-PABA:xylose test were not caused by PABA malabsorption. Xylose values were similar to values obtained by the BT-PABA:xylose test. It was concluded that: (1) the BT-PABA:xylose test is a practical test for detecting maldigestion or malabsorption in the dog; (2) dogs with intestinal malabsorption may have functional PEI; and (3) decreased PABA plasma values obtained by BT-PABA:xylose testing are not caused by malabsorption of free PABA.
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PMID:Simultaneous evaluation of pancreatic exocrine function and intestinal absorptive function in dogs with chronic diarrhea. 696 49

Steatorrhea persists in most cystic fibrosis patients with exocrine pancreatic insufficiency despite enzyme replacement, perhaps because gastric acid inactivates oral enzymes. Bile acid malabsorption may parallel steatorrhea. We studied the effect of adding cimetidine (300 mg a.c.) to pancreatic enzyme therapy in 8 patients with cystic fibrosis and steatorrhea. Fecal bile acid, weight and fat, and postprandial serum bile acids were measured with and without cimetidine. D-Xylose absorption was normal in all patients. On constant diets, 72-hr stools were collected during enzyme therapy and during a 5-day course of enzymes plus cimetidine. Addition of cimetidine to enzyme decreased fecal weight (257 +/- 32.6 to 198.6 +/- 32.5 g/day), increased the percent of dietary fat absorbed (75.0 +/- 4.9 to 80.1 +/- 4.1%, P less than 0.05), but had no effect on fecal bile acids (4.7 +/- 0.9 to 4.2 +/- 1.0 mmol/m2/day). Compared with no therapy, enzymes increased postprandial serum bile acid at 60 min (9.56 +/- 1.0 to 14.0 +/- 1.3 muM/liter, P less than 0.05) and at 120 min (9.4 +/- 1.2 to 12.4 +/- 1.6 muM/liter, P less than 0.02). The addition of cimetidine to enzymes abolished this postpranidial bile acid rise. In conclusion, addition of cimetidine to oral pancreatic enzyme therapy decreases stool weight and fat but perhaps not stool bile acids in cystic fibrosis. However, correction of fat absorption is incomplete. Enzyme therapy increases postprandial serum bile acids, and this increase is abolished with oral cimetidine. In view of the incomplete correction of steatorrhea and the alterations in serum bile acids induced by cimetidine, further research with this new medication is needed before it can be recommended for routine clinical use in patients with cystic fibrosis.
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PMID:Effect of cimetidine and pancreatic enzymes on serum and fecal bile acids and fat absorption in cystic fibrosis. 738 Feb 1

Duodenal bile salt concentrations were measured throughout one day in six patients with primary biliary cirrhosis while they were eating a normal ward diet. Five of them had lost weight; none had ascites. Each patient had a radiologically normal small bowel and a normal jejunal biopsy. No clear relationship between high faecal fat excretion and abnormally low duodenal bile salt concentration was found. Xylose absorption was abnormal in five patients. If weight loss in primary biliary cirrhosis is due to malabsorption, factors other than a reduced small intestinal bile salt concentration must be important.
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PMID:Weight loss in primary biliary cirrhosis. 742 37


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