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)

A case report is given of a patient with a malabsorption syndrome. Primary diagnostic procedures including x-ray examinations and endoscopy yielded no results. Alterations of the abdominal lymph vessel system were found during peritoneoscopy giving rise to the hypothetical diagnosis of Whipple's disease. This diagnosis was confirmed by intestinal biopsy yielding macrophages with PAS-positive inclusion bodies. It is pointed out, that peritoneoscopy is a good means to evaluate the abdominal lymph vessel system.
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PMID:[Peritoneoscopic diagnosis of M. Whipple--making an indirect diagnosis (author's transl)]. 7 75

A case report is given of a 73 years old woman suffering from Whipple's disease. Intermittant polyarthralgias, diarrhea, weight loss and laboratory signs of malabsorption had been present for 6 years, when diagnosis was established by biopsy: pathognomonic PAS-positive macrophages were demonstrated in the duodenal mucosa. A complete remission of the disease could be achieved after 100 mg of doxycycline had been administered continuously for a year. Some special details of the course of Whipple's disease in the higher age group are discussed.
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PMID:[Whipple's disease in an elderly person (author's transl)]. 9 35

A patient aged 45 suffering from Whipple's disease is described. The disease has been diagnosed on the basis of morphologic examination of a biopsy specimen of the small intestine mesenteric lymph node. The patient had suffered from the disease for 14 years; during the last 6 months he developed symptoms of the malabsorption syndrome with diarrhea and steatorrhea. The lymph nodes contained numerous macrophages with PAS-positive glycoprotein granules in the cytoplasm, small cavities filled with lipids; electron microscopy has revealed bacillus-like bodies in the macrophages and outside the cells. After the disease has been diagnosed, the patient has been administered a course of tetracycline therapy, that resulted in an improvement of his status.
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PMID:[The morphology of mesenteric lymph nodes in Whipple's disease]. 246 43

At endoscopy, a 30-year-old man with acquired immune deficiency syndrome (AIDS), Kaposi's sarcoma, diarrhea, and unexplained malabsorption showed erythematous macular duodenal lesions consistent with Whipple's disease by histology and electron microscopy. Symptoms did not respond to tetracycline. Subsequent cultures revealed systemic Mycobacterium avium (M. avium) infection. Tissue from this patient, from patients with Whipple's disease and from a macaque with M. avium were compared. All contained PAS-positive macrophages but M. avium could be distinguished by positive acid-fast stains and a difference in pattern of indirect immunofluorescence staining with bacterial typing antisera. PAS-positive macrophages in the intestinal lamina propria are no longer pathognomonic of Whipple's disease. Ultrastructural and histological similarities between Whipple's disease and M. avium infection suggest that both are manifestations of immune deficits limiting macrophage destruction of particular bacteria after phagocytosis. M. avium must be considered in the differential diagnosis of diarrhea in patients with AIDS and other immunosuppressed conditions.
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PMID:Intestinal infection with Mycobacterium avium in acquired immune deficiency syndrome (AIDS). Histological and clinical comparison with Whipple's disease. 258 Jun 79

Extensive brownish discoloration of the small bowel is rare and has been described mainly in association with malabsorption disorders. It is related to deficiency of the fat soluble vitamin E. Vitamin E is an antioxidant substance that prevents peroxidation of unsaturated fatty acids. Vitamin E deficiency may result in oxidized lipids, which when polymerized with polysaccharides form the brown, PAS-positive pigment termed ceroid or lipofuscin. The deposition of pigmented granules in the effected tissues accounts for the brownish discoloration. We present three patients ultimately found to have "brown bowel syndrome (BBS)," in which the symptoms, preoperative findings, and respective diagnoses were different. In all three patients, serum Vitamin E levels were found to be extremely low.
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PMID:Brown-bowel syndrome. 277 66

With regard to three cases, one of them relapsing after four years, a short survey on Whipples's disease is given. The 3 male patients of medium age suffered from malabsorption and foregoing arthralgia. These symptoms are typical. In most cases first of all chronic infectious or neoplastic diseases are taken into consideration. The finding of PAS-positive macrophages in biopsies of the duodenal mucosa is key to the diagnosis, allowing the successful antibiotic therapy, with preference to oxytetracyline.
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PMID:[Whipple's disease]. 618 27

An unusual case of Whipple's disease is reported. The diagnosis was difficult as the characteristic digestive sign and symptoms (malabsorption, diarrhea, mucosal infiltration by PAS-positive macrophages) were absent. After a ten-year history of seronegative arthritis, myocardiopathy, with aortic insufficiency, basilar pulmonary infiltrates, enlarged lymph nodes, the patient, a 56 years old man, was referred to us for a severe vegetative and neurological dysfunction: stupor, dysarthria, akinesia, hypertonia, hypothermia and abnormal thirst. A CT-scan showed a low-density area of the right hypothalamus, and PAS-positive macrophages were found in a lymph node, in the CSF and in a cerebral biopsy. The patient then received a classical antibiotic treatment, yet the neurologic dysfunction remained severe. Finally, a trial with rifampicin brought a striking improvement of the patient's condition, which has now lasted for three years.
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PMID:[Hypothalamic form of Whipple's disease. Favorable effect of rifampicin]. 619 50

Whipple's disease is an inflammatory illness primarily afflicting middle-aged men. Although originally seen as a disease of intestinal malabsorption, it may affect any body system causing numerous signs and symptoms. These are due to infiltration of macrophages containing sickleform particles which stain PAS-positive. Definitive diagnosis is made by biopsy, and treatment is with broad-spectrum antibiotics. There seems to be an infectious component to the disease although defective immunologic responses may be implicated. Exact etiology is unknown. Although a rare illness, there has recently been increased recognition of this disease. Neurological involvement occurs with dissemination of lesions to the nervous system. Symptoms are quite varied but most often include dementia. As is apparent from the patient history, early diagnosis and treatment is imperative. Even without symptoms, there should probably be treatment for central nervous system involvement since neurological manifestations are often fatal. The case study presented illustrates a multisystem illness. The neurological presentation includes peripheral neuropathy, cranial nerve involvement, brainstem dysfunction, endocrine disturbance, thalamic or pituitary symptoms, and changes in cerebral function. Nursing measures reinforce the importance of the role of primary nursing for patient care and the necessity of comprehensive nursing care plans. Management problems were alleviated by providing consistency and continuous orientation, by involving the patient and his family in the plan of care, and by establishing a safe and consistent environment. Nursing process can improve and enhance patient responses, family coping ability, and the quality of care given. A "difficult" patient can help to expand nursing knowledge as well as promote personal growth and satisfaction.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Neurological involvement with Whipple's disease. 620 14

The management of MDR-TB requires that the clinician become familiar with the "second-line" antimycobacterial agents. These drugs are generally less potent and frequently more toxic than isoniazid and rifampin. Because they are less active, innovative dosing schedules may allow us to take advantage of the few strengths that they possess. This approach will require further research into the dose-response relationships for each agent. Based on our current knowledge of these drugs, practical guidelines for their use have been described. These guidelines include the gradual escalation of the oral doses of PAS, cycloserine, and ethionamide over several days, and the intravenous administration of streptomycin and capreomycin. Both ciprofloxacin and ofloxacin may be used for the treatment of MDR-TB, but data from clinical trials are currently lacking. Finally, because patients with AIDS appear to develop antimycobacterial drug malabsorption over the course of their HIV infection, therapeutic drug monitoring can be used to verify drug absorption in the individual patient. This approach may improve therapy for that patient and prevent the selection of additional drug resistance.
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PMID:Pharmacology of the antimycobacterial drugs. 823 10

A 52 year old lady was admitted for progressive pedal oedema over a six year period and recent onset of hyperpigmentation. Laboratory investigations revealed that she was having a malabsorption syndrome with protein losing enteropathy. In view of associated arthralgia and higher mental function disturbances, a clinical diagnosis of Whipple's disease was postulated. Duodenal biopsy revealed infiltration of the lamina propria with PAS positive macrophages, suggestive of Whipple's disease. This case is being reported to highlight that Whipple's disease can manifest in the most unsuspecting manner and that early treatment can cure the patient.
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PMID:Whipple's disease. 1183 85


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