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Tropical sprue: revisited.
1Division of Gastroenterology, Department of Medicine, Shifa International Hospital and Shifa College of Medicine, Islamabad.
Summary
Tropical sprue, characterized by diarrhea, weight loss, and anemia, shows partial villous atrophy on biopsy. Treatment with tetracycline and folic acid led to successful symptom resolution and weight gain in all patients.
Area of Science:
- Gastroenterology
- Tropical Medicine
- Internal Medicine
Background:
- Tropical sprue is a malabsorption syndrome prevalent in tropical regions.
- Clinical manifestations include diarrhea, anorexia, weight loss, and anemia.
Purpose of the Study:
- To review patient experiences with tropical sprue.
- To assess diagnosis, management, treatment response, and follow-up.
Main Methods:
- Retrospective descriptive study at a single center (January 1994 - January 2003).
- Included patients with diarrhea, anorexia, weight loss, anemia, partial villous atrophy on biopsy, and response to antibiotics and folic acid.
Main Results:
- 42 patients (31 males, 11 females) aged 17-66 years were studied.
- All presented with diarrhea, weight loss, anorexia, and megaloblastic anemia.
- Distal duodenal biopsy showed partial villous atrophy in all cases.
- Treatment with tetracycline (1g/day) and folic acid (5mg/day) for 3 months resulted in complete symptom resolution and weight gain within 4 weeks.
- Mean follow-up of 5 years showed no relapses.
Conclusions:
- Tropical sprue presents with characteristic symptoms and megaloblastic anemia.
- Partial villous atrophy is a consistent finding on intestinal biopsy.
- Treatment with tetracycline and folic acid is highly effective for tropical sprue.
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