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[Histological changes of the distal ileum in chronic diarrhea associated with megaloblastic anaemia]
Elizabeth Ayala1, Oscar Frisancho, Pedro Chacón Yupanqui
1Departamento del Aparato Digestivo, Hospital Nacional Edgardo Rebagliati Martins--EsSalud, Lima, Peru.
Abstract:
Histological changes of the distal ileum were evaluated in thirteen (13) patients suffering from chronic diarrhea associated with Megaloblastic Anaemia (MA). The patients were seven (7) men and six (6) women with an average age of 55.6 (34-74). They were all diagnosed with MA and treated with cianocobalamin and folic acid, which resulted in fast recovery. Follow up on the patients did not show any other cause related to chronic diarrhea. Biopsies from the distal ileum were taken by colonoscopy. Endoscopy findings were not relevant except for a light paleness or slightly-rough mucose. The following changes were found by examining the histological radiographies: chronic inflammatory infiltration 92% (12), intestinal villous atrophy 62% (8), erosions at villous surface 46% (6), slight ectasia of the lymphatics 46% (6), flattening of the epithelium cells of the villous 38% (5), and focal fibrosis 38% (5). The patients suffering chronic diarrhea associated with MA showed significant changes of the distal intestinal mucose (ileum). Those changes are probably also in the surrounding area and could explain not only the chronic diarrhea, but the poor absorption observed on some of the patients. The quick response to cobalamins and folates treatment showed the important role of these elements in intestinal restoration.
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