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)

In 23 patients with dermatitis herpetiformis (DH) and five patients with linear-IgA bullous dermatosis (BD), we evaluated the occurrence of histologic jejunal changes and small-bowel function abnormalities. None of the patients showed clinical signs or symptoms of malabsorption. Morphological jejunal changes consistent with gluten-sensitive enteropathy were found in 82% of DH patients and in 60% of BD patients. However, BD patients showed only mild jejunal histologic abnormalities, whereas more severe jejunal lesions were found in most patients with DH. Functional tests showed a rough correlation with the severity of the jejunal lesions, being almost completely normal in BD patients and DH patients with mild intestinal damage, whereas most of DH patients with subtotal or total villous atrophy showed abnormal d-xylose tests and folic acid assays. Lactose tolerance tests (H2 breath test and blood glucose after oral lactose load) showed no correlation with the degree of jejunal damage.
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PMID:Small-bowel involvement in dermatitis herpetiformis and in linear-IgA bullous dermatosis. 635 70

Ten pediatric patients investigated for chronic diarrhea, chronic weight loss, or failure to thrive were found on intestinal biopsy and/or in a duodenal aspirate to have Giardia lamblia. Serum immunoglobulin levels were normal or elevated in all patients. Three children had increased excretion of fecal fat and three other children had low D-xylose absorption. Jejunal biopsy specimens showed two severe, three moderate, and two mild morphological abnormalities, and three were normal. Except for lactase deficiency, disaccharidase activities correlated poorly with the severity of mucosal damage on biopsy. Steatorrhea was seen only with the more normal biopsies. Immunofluorescent staining of the biopsies for IgG, IgM, IgA, and secretory piece revealed no immune defects. Thus, there was no single malabsorption defect associated with giardiasis, and the specific defects did not necessarily correlate with morphological changes.
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PMID:Giardiasis in childhood: poor clinical and histological correlations. 635 23

Intragastric bacterial colonization is well known in pernicious anaemia (PA), but its consequences have rarely been investigated. We have studied the clinical history, blood samples, and endoscopic biopsies from the stomach and duodenum of 80 patients with PA. In a random subgroup of 22 patients gastric juice was collected for aerobic culture and for estimation of nitrate, nitrate-reducing bacteria, nitrite, and N-nitrosamines; duodenal juice was studied in parallel in eight of these subjects. Gastric and duodenal juice had high bacterial counts; faecal organisms were found in 14 patients. The mean count of nitrate-reducing bacteria was significantly higher than in a control group of patients with peptic ulcer disease (p less than 0.001), as was the nitrite concentration (p less than 0.001). Thirty-three of the 80 patients had gastric dysplasias; 1 early gastric carcinoma was also found. Duodenitis was present in 39 out of 80 cases, in 6 associated with partial villous atrophy. A history of malabsorption and/or chronic intermittent diarrhoea was obtained significantly more often from patients with duodenitis. Four patients developed acute gastroenteritis shortly before or during the time of the study, two having a salmonella infection. Bacterial overgrowth in PA may be facilitated by altered immunological conditions, since low serum levels of IgA and IgG were found in this patient group.
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PMID:Pernicious anaemia, intragastric bacterial overgrowth, and possible consequences. 674 Feb 11

An 18-year-old-woman, with dermatitis herpetiformis, acute glomerulonephritis, malabsorption and villous atrophy due to massive infiltration of IgA producing plasma cells was studied. By light microscopy, her renal biopsy specimen showed heavy immunofluorescence for IgA, a mixed proliferative and membranous lesion with occasional crescents and focal sclerosis. Electron microscopic examination revealed three main lesions: (1) swelling and bleb formation in endothelial cells, (2) extensive fusion of foot processes of podocytes, and (3) a dense quasi-linear, continuous deposition of immune complexes, encompassing several loops; they were characteristically located within the basement membrane at the boundary between the lamina densa and the lamina rara interna. At occasional points where the immune complexes had reached the outer aspects of the basement membrane, there was damage to the podocyte cytoplasm. This electron microscopic aspect supports the interpretation that these immune complexes, although non-complement fixing, exhibit a high damaging potential, leading to relentless disease progression.
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PMID:IgA pseudo-linear deposits in glomerular basement membranes in dermatitis herpetiformis. 705 9

A morphometric and immunohistochemical restudy was made of jejunal biopsy specimens from 5 patients with soy allergy and the results obtained were compared to those from specimens taken before soy feeding and to those at a later time. All the patients had had previous cow's milk allergy with malabsorption. Gastrointestinal symptoms presented within two weeks of starting the soy based formula but in two patients the symptoms were mild and these patients were able to continue soy feeding. Jejunal biopsy specimens taken within 3 days from the reaction to soy showed villous atrophy associated with crypt hyperplasia and an increased cell renewal rate. Also, these specimens showed an inflammatory reaction in the lamina propria and in the epithelium, and the numbers of IgA- and IgM-containing cells were increased. Later, when the soy proteins were eliminated, the morphology of the jejunum improved and the cell numbers were reduced to normal. The intestinal damage and the local immune reaction caused by soy proteins are similar to those seen in cow's milk allergy with malabsorption. The immunological mechanisms operating in these diseases are thought to be the cause of these changes.
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PMID:Morphometric and immunohistochemical study of jejunal biopsies from children with intestinal soy allergy. 719 37

Selective serum IgA deficiency and follicular lymphatic hyperplasia of the terminal ileum were observed in a 30-year-old patient. Due to the relative ileal stenosis he complained of colicky abdominal pains particularly after flatulant food. There was no malabsorption syndrome or lambliasis. Although immunohistochemically IgA producing plasma cells were demonstrated in the intestinal wall, no immunoglobulin could be demonstrated in the intestinal juice, suggesting a secretory defect. The very high percentage of IgE producing plasma cells was noteworthy, these cells having led to the macroscopical picture of follicular hyperplasia. Due to the relative frequency of IgA deficiency (about 1 : 700) and the known increased incidence of malignant disease regular surveillance of these patients is indicated.
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PMID:[Follicular lymphatic hyperplasia of the small intestine in antibody deficiency syndrome (author's transl)]. 723 22

In a reappraisal study of coeliac disease (CD) 38 children and adolescents were studied: 20 (group A) had a previous diagnosis of CD from early childhood but had been lost to follow-up, 18 (group B) had in infancy or early childhood been hospitalized for more than 1 month for different gastro-intestinal symptoms without receiving a diagnosis of CD. In the present study the patients had a clinical examination and Hb, serum IgA and folate were analysed. These investigations did not prove helpful in selecting coeliac cases. Intestinal biopsy revealed CD in 8 patients in group A and in 6 patients in group B. Thus the frequency of CD was almost the same in the two groups. All 14 patients with CD had very few complaints, when a careful medical history was taken before biopsy. The present study shows the importance of performing intestinal biopsy on liberal indications on patients with an infancy or early childhood history of malabsorption-related symptoms. Among these patients many coeliacs are likely to be found.
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PMID:Transient gastro-intestinal disorders during infancy and early childhood. A follow-up study with special reference to coeliac disease. 724 30

Jejunal mucosa biopsies from non-immune deficient patients with Giardia lamblia infestation were examined and showed three different groups of mucosal changes, distinguishable on morphological and immunohistochemical grounds. In three patients no morphological or immunohistochemical abnormalities were found (group A). In five patients a normal villous architecture was seen. These biopsies had increased numbers of interepithelial lymphocytes and of immunoglobulin containing cells in the lamina propria, with a relative increase of the number of IgA and IgG containing cells (group B). Two patients with a malabsorption syndrome due to giardiasis had marked villous atrophy, documented by morphometric measurements and large numbers of interepithelial lymphocytes and of immunoglobulin containing cells in the lamina propria, especially IgA and IgG (group C). These findings differ considerably from those in patients with immunodeficiency or gluten sensitive enteropathy. This suggests that when villous atrophy of the jejunal mucosa is found immunohistochemistry of jejunal biopsy specimens may be helpful in the differential diagnosis between mere giardiasis and giardiasis superimposed on immunodeficiency or gluten sensitive enteropathy.
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PMID:Quantitative histological and immunohistochemical findings in jejunal biopsy specimens in giardiasis. 729 76

The case of a 42-year-old-man with dissociated deficiency of immunoglobulins and intestinal malabsorption is presented. The gastrointestinal symptoms included post-prandial pains and steatorrhea. Histologic and immunohistochemistry studies of small intestinal biopsies revealed subtotal villous atrophy and absence of IgA producing plasma cells. The deficiency of immunoglobulins was total for IgA and moderate for IgM. IgG was increased. HLA B8 haplotype was present Gluten-free diet gave dramatic improvement in few days on clinic symptoms. Recovery of the villi was observed within three months. The cases reported in the published literature are reviewed and the physiopathologic hypothesis and nosology limits of the syndrome are discussed.
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PMID:[Intestinal malabsorption with a dissociated deficiency of immunoglobulins (author's transl)]. 729 93

Between July 1985 and June 1990, we prospectively investigated 236 children suspected of having malabsorption syndrome. Each patient had a xylose absorption test and small intestinal biopsy. Blood samples were collected to AGA assay. The aim of the study was to evaluate the use of antigliadin antibodies test, IgG and IgA, in screening celiac disease for intestinal biopsy and in the monitoring of gluten-free diet and challenge in celiac patients. Twenty patients were diagnosed with celiac disease confirmed by three small intestinal biopsies; 12 patients were suspected of having celiac disease, with two biopsies, before and one year after a gluten-free diet; 106 patients had environmental enteropathy; 45 patients had protracted diarrhea and 56 children had failure to thrive with no gastrointestinal symptoms. The AGA test was considered a reliable test in screening for biopsy and in the differential diagnosis between celiac disease and other causes of malabsorption syndrome. The IgG AGA test had high sensitivity (90.4%) and the IgA AGA test had high specificity (92.1%) in screening for celiac disease. In the follow-up of the celiac patients the antibody levels were significantly higher during gluten containing diet than after gluten avoidance being thus a reliable test to evaluate dietary compliance.
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PMID:[Serum antigliadin antibodies in the diagnosis and follow-up of celiac disease]. 757 76


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