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Cyclosporin-responsive enteropathy and protracted diarrhea.
M Coulthard1, J Searle, M Patrick
1Department of Gastroenterology and Nutrition, Royal Children's Hospital, Brisbane, Australia.
Journal of Pediatric Gastroenterology and Nutrition
|February 1, 1990
Summary
A child with severe secretory diarrhea and intestinal inflammation refractory to standard treatments experienced dramatic recovery with cyclosporin. This suggests immune factors play a role and cyclosporin may be a valuable treatment option.
Area of Science:
- Pediatric Gastroenterology
- Immunology
- Inflammatory Bowel Disease
Background:
- Severe protracted secretory diarrhea and subtotal villus atrophy can be debilitating in children.
- Refractory cases often lack identifiable infectious or metabolic causes, necessitating extensive supportive care.
Observation:
- A 19-month-old child presented with severe secretory diarrhea, subtotal villus atrophy, and intestinal inflammation.
- The condition was refractory to nutritional support, steroids, and anti-inflammatory agents, requiring 18 months of total parenteral nutrition.
Findings:
- Introduction of cyclosporin led to a dramatic resolution of secretory diarrhea and enteropathy.
- Discontinuation of cyclosporin resulted in symptom relapse, with improvement upon reintroduction.
Implications:
- This case highlights a potential immune-mediated mechanism in refractory pediatric enteropathy.
- Cyclosporin demonstrates therapeutic potential for similar cases, warranting further investigation.