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)

The effects of endocrine disease on bone mass continue to attract attention. Investigations include the effects on the skeleton of thyroid disease, primary hyperparathyroidism, and their treatment. The effect of growth hormone replacement in adults with panhypopituitarism has also been investigated; children with treated growth hormone deficiency appear to reach adulthood with low bone mass. The indications for surgery in asymptomatic primary hyperparathyroidism have recently been reviewed. The associations between autoimmune thyroid disease and connective tissue disease have been investigated. Although patients with Graves' disease are frequently positive for antinuclear antibodies, there appears to be no increased risk of systemic autoimmune disease. The possible pathogenesis of diabetic bone disease via calcium malabsorption, hypercalciuria, reduced bone formation, and collagen abnormalities has been reviewed. A long-term study has clarified the links among diabetic control, limited joint mobility, nephropathy, and retinopathy. The possible mechanisms by which pregnancy may induce remission in rheumatoid arthritis have been discussed.
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PMID:Endocrine disease. 843 94

The pathophysiology and treatment of colonic motility disorders are reviewed. Colonic dysfunction is a common reason for patients to seek medical care, although patients' perceptions may not reflect abnormal function. Abnormalities in colonic function can result from a primary disorder of the large intestine or from metabolic, neurologic, collagen vascular, neoplastic, or infectious diseases. Irritable bowel syndrome, a common disorder of colonic motility, can be caused by alterations in colonic neuromuscular functions, afferent neural function, or psychosocial factors. Colonic dysmotility can also result from malabsorption of carbohydrates. The most severe form of altered colonic motility is acute colonic pseudo-obstruction. Diagnostic studies should be limited to tests appropriate for the patient's symptoms and apparent severity of disease. Most motility disorders are functional disorders and do not result in abnormal studies. Pharmacotherapy should be directed by objective measures, the most useful of which are measurement of whole gut transit time and quantification of the water content of stools. Treatment should be determined by the nature of the disorder and the symptoms involved. For constipation, treatment should begin with changes in diet, fluid and fiber intake, and concurrent medications. Irritant laxatives can have damaging effects and should not be used habitually; however, polyethylene glycol-based purgatives can be helpful. Newer prokinetic agents, such as cisapride, have been shown to promote colonic motility. For selected patients with intractable constipation, surgery has a good success rate. For patients with functional diarrhea, opioid analogues can increase fluid absorption and delay transit.
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PMID:Challenges in the treatment of colonic motility disorders. 893 27

In 1970 a case of malabsorption with flat small intestinal mucosa with subepithelial collagen deposition was described. There was no response to a gluten-free diet, and the condition was termed collagenous sprue. We report a case of coeliac disease with subepithelial deposition of collagen in duodenal biopsy, which responded to a gluten-free diet.
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PMID:[Celiac disease with subepithelial deposition of collagen]. 1101 88

Systemic sclerosis (SSc) is a chronic connective tissue disease characterized by fibrosis and destruction of the microvasculature. Increased deposition of collagen and other extracellular matrix components affects not only the skin but most of the internal organs including lungs, heart, kidneys and the gastrointestinal (GI) tract. Within the GI tract, esophageal involvements are most frequently seen features. However, abnormalities in the small intestine, colon and anorectum may also occur. A retrospective study was performed to investigate the frequency and clinical relevances of GI involvement in patients with SSc. Charts of altogether 246 SSc patients were reviewed. This patient population included 40 males and 206 females, with a mean age of 54.2 years. In general, 176 of 246 patients (71.5%) had GI symptoms. Esophageal involvement including gastro-esophageal reflux disease (GERD), aperistalsis, pseudodiverticuli, etc. was the most common (62.6%). In addition, diseases of the stomach (31.7%), dysfunctions of the colon and anorectum (11.4%), as well as sclerosis of the biliary tract and other pancreato-biliary disorders (9.8%) also occurred. Diarrhea and malabsorption resulted in cachexia and other secondary complications leading to death in two cases. Our results support that GI manifestations are rather common in SSc. Apart from the esophagus, other GI complications in SSc are usually mild, however, early recognition is necessary to improve quality of life.
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PMID:Gastrointestinal manifestations in Hungarian scleroderma patients. 1677 Jun 15

Collagenous sprue (CS) is a rare disease of the small bowel, which is characterized by complete atrophy of mucosal villi and excessive subepithelial collagen deposition. The authors describe a 40-year-old patient, who was examined for severe malabsorption syndrome. The diagnosis of celiac disease was based upon serological and histological data, but gluten-free diet was not effective and only treatment with prednisolone led to positive changes. Another histologic study revealed a focal deposit of collagen under the epithelium in addition to signs of intestinal mucosal atrophy, and the diagnosis of CS was made. The case is discussed from the positions of known information of CS.
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PMID:[Collagenous sprue: a case description]. 1752 Aug 95

The term "nutritargeting" in analogy to the term "drug targeting" means targeting nutrients to specific "target" tissues. What is the rationale for this idea? Some tissues obviously are able to accumulate micronutrients selectively and to use them predominantly for specific functions. It has, for instance, been known for a long time that the accumulation of beta-carotene in the skin does not only provide a "golden-yellow" color but considerable antioxidative protection as well. Yet beta-carotene is only one of many antioxidants, which can be detected in the skin. Other carotenoids, for example, lutein and zeaxanthine, are preferentially found in the macula lutea, the so-called yellow spot in the eye. Here, carotenoids are subject to a metabolism typical for that tissue, which cannot be found in other tissues (e.g., formation of meso-zeaxanthine). In addition, they can specifically be absorbed into the macula. In the macula, they protect the retinal pigment epithelial cells against oxidative damage from UV light. Indeed, these two carotenoids can be protective against age-dependent macula degeneration. Another example is the tissues that are particularly rich in vitamin C, for example, the cortex of the suprarenal gland or the lens: here, vitamin C fulfills both antioxidative functions and metabolic ones as it helps in the formation of collagen structures. Approximately 40% of the body's ascorbate is stored in skeletal muscle because this tissue is relatively abundant and its cellular concentration is tenfold higher than the plasma level. Similarly, the intracellular ascorbate concentration in the brain (3 mM) greatly exceeds the level in the extracellular fluid (200-400 muM). The majority of ascorbate is stored in the astroglial cells that are capable of reducing great quantities of DHAA to ascorbate, which then becomes available for release back into the extracellular fluid. Thus, the accumulation of vitamins respectively micronutrients in single tissues is not limited to a pure storage process like the storage of vitamin A in the liver, but is often connected with important and tissue-specific metabolic functions. When single micronutrients are applied for prevention or even intervention in diseases of organs or tissues, they are usually administered in higher doses for a longer period of time. The hope is to accumulate it this way sufficiently in the tissue and to thus be able to ensure the therapeutic success. This procedure, however, leads to a "flooding" of the whole organism with micronutrients and their potential enrichment in tissues which would usually not accumulate the respective micronutrient. Thus, unexpected side effects may occur. An attractive solution to these problems in the future could be to wrap up or apply micronutrients in such a way that they can selectively reach the targeted tissue. For this approach, called "drug targeting" by pharmacologists, one could introduce the analogous expression "nutritargeting" with respect to micronutrients. For such a nutritargeting there are already a lot of examples and developments which show that it is possible to accumulate micronutrients in target tissues while simultaneously circumventing or protecting other tissues. A substantial requirement for the development of "carriers" for nutritargeting is the availability of procedures or specific carriers, which allow the selected nutrients to bypass the main barriers that are encountered when, for example, circumventing the enteral route in the targeting process. The entrance areas for such a targeting are the nasal mucosa, the oral mucosa, the cornea, the skin, or the lung. In the case of enteral application of proteins, the packaging has to resist gastric digestion and the body must be able to absorb the particles through the intestinal mucosa without hydrolyzing the proteins in order for them to reach the systemic circulation. Another field in which nutritargeting may play an important role is the diseases where either systemic absorption is not possible (e.g., malabsorption/maldigestion) or where local deficits occur, which may not or only inadequately be supplied by systemic application.
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PMID:Nutritargeting. 1829 7

Impaired functioning of the gastrointestinal system may also contribute to malnutrition and cardiac cachexia (CC) in patients with chronic heart failure (CHF). Targets for future interventions include the deranged hormonal systems involved in energy balance as well as malabsorption from the gut and dietary supplementation. Other targets are the inhibition of proteasome-dependent protein degradation and the direct inhibition of pro-inflammatory pathways. The beneficial effects of ACE inhibitors, aldesterone inhibitors and beta-blockers in preventing or delaying the collagen deposition in the small intestine wall need to be elucidated. We strongly believe that by improving our understanding of the role of the gut in CC will lead to the development of novel therapeutic strategies in the near future.
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PMID:The small intestine: a critical linkage in pathophysiology of cardiac cachexia. 2111 52

Collagenous sprue is a rare form of small bowel enteropathy characterized by chronic diarrhea and progressive malabsorption with little data available on its natural history. The pathologic lesion consists of subepithelial collagen deposition associated with variable alterations in villous architecture. The small bowel biopsies of 12 cases were reviewed. Clinical details, celiac serology, and T-cell receptor gene rearrangement study results, when available, were collated. There were 8 females and 4 males (age ranged from 41 to 84 y) who presented with chronic diarrhea and weight loss. Small intestinal biopsies showed subepithelial collagen deposition with varying degrees of villous atrophy and varying numbers of intraepithelial lymphocytes. Four patients had previous biopsies showing enteropathic changes without collagen deposition. Seven cases were associated with collagenous colitis and 1 also had features of lymphocytic colitis. Three patients also had collagen deposition in gastric biopsies. One case was associated with lymphocytic gastritis. Celiac disease (CD, gluten-sensitive enteropathy) was documented in 4 patients. Five patients made a clinical improvement with combinations of a gluten-free diet and immunosuppressive therapy. Two patients died of complications of malnutrition and 1 of another illness. Clonal T-cell populations were identified in 5 of 6 cases tested. Four of these patients improved clinically after treatment but 1 has died. Collagenous sprue evolved on a background of CD in 4 cases. There was no history of CD in others and these cases may be the result of a biologic insult other than gluten sensitivity. None has developed clinical evidence of lymphoma to date.
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PMID:Collagenous sprue: a clinicopathologic study of 12 cases. 1964 52

Two patients underwent uneventful total removal of convexity or trigone meningioma, but subsequently edema enlarged causing symptoms 3-4 weeks later. Gradual improvement was obtained by steroid administration in 1 patient and re-craniotomy in 1 patient. The histological findings in Case 1 were not confirmed, but inflammatory reaction against residual microfibrillar collagen hemostat (MCH) may have developed. The specimen from around the cyst in Case 2 showed moderate staining for vascular endothelial growth factor (VEGF). VEGF secreted by the tumor might have resulted in spread of inflammation due to MCH in the brain parenchyma. Furthermore, inflammatory reactions may have obstructed or formed a one-way communication in the inferior horn and residual cavity, resulting in malabsorption of cerebrospinal fluid. Postoperative edema with the timing in these cases is difficult to anticipate. However, the risk of this phenomenon can probably be minimized by ensuring that MCH is removed as effectively as possible after use, or by refraining from use in the brain parenchyma and by taking care to connect the residual cavity to the ventricular system, particularly if the tumor contacts a cerebral ventricle.
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PMID:Delayed enlargement of brain edema after resection of intracranial meningioma: two case reports. 1985 47

Celiac disease (CD) is manifested by a variety of clinical signs and symptoms that may begin either in childhood or adult life. Neurological symptoms without signs of malabsorption have been observed for a long time in CD. In this report, an 8-year-old girl with CD presented with rarely seen dilated cardiomyopathy and stroke. The girl was admitted with left side weakness. Her medical history indicated abdominal distention, chronic diarrhea, failure to thrive, and geophagia. On physical examination, short stature, pale skin and a grade 2 of 6 systolic murmur were detected. Muscle strength was 0/5 on the left side, and 5/5 on the right side. Coagulation examinations were normal. Tests for collagen tissue diseases were negative. Factor V Leiden and prothrombin GA20210 mutations were negative. Tandem mass spectrophotometry and blood carnitine profiles were normal. Brain magnetic resonance imaging and cerebral angiography showed an infarction area at the basal ganglia level. Examinations of serologic markers and intestinal biopsy revealed CD. We emphasize that in differential diagnosis of ischemic stroke, CD should be kept in mind.
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PMID:Stroke and dilated cardiomyopathy associated with celiac disease. 2045 70


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