Microvillous Inclusion Disease as a Cause of Protracted Diarrhea
Ravi Hari Phulware1, Gaurav P S Gahlot2, Rohan Malik3
1Department of Pathology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.
Abstract:
Microvillous inclusion disease (MVID), also known as congenital microvillus atrophy, was first described by Davidson et al. in 1978. Till date, only a handful of cases with MVID have been described in English literature. It is an autosomal recessive disorder with no sex predisposition and more commonly noted in countries with prevalent consanguineous marriages. These patients usually present with intractable secretory diarrhea in early days of life. The pathognomonic findings of MVID are villous atrophy along with the formation of intracellular microvillous inclusions on electron microscopy. Till date, no curative therapy exists, and prognosis mainly depends upon parenteral nutrition. Small bowel transplantation is one of the treatment options. Clinician and pathologist should consider the possibility of MVID in the differential diagnosis of chronic intractable diarrhea in an infant. Herein, authors are describing a case of intractable diarrhea with MVID phenotype diagnosed in a 3-mo-old male child who presented with intractable diarrhea in an outside hospital, and the diagnostic workup was performed by the authors on endoscopic biopsy sample.
Insights
Microvillous inclusion disease (MVID) is a rare genetic disorder causing severe diarrhea in infants. Early diagnosis through biopsy is crucial for managing this condition, as treatments are limited.
Area of Science:
- Gastroenterology
- Pediatric Pathology
- Genetics
Background:
- Microvillous inclusion disease (MVID), or congenital microvillus atrophy, is a rare autosomal recessive disorder.
- It presents as intractable secretory diarrhea in newborns, often in regions with consanguineous marriages.
Observation:
- The case involves a 3-month-old male infant with a history of intractable diarrhea.
- Diagnostic workup was performed on an endoscopic biopsy sample.
Findings:
- Pathognomonic findings include villous atrophy and intracellular microvillous inclusions on electron microscopy.
- This case highlights the MVID phenotype in an infant presenting with severe diarrhea.
Implications:
- MVID requires consideration in the differential diagnosis of chronic infant diarrhea.
- Parenteral nutrition and potentially small bowel transplantation are current management strategies.
- Further research into MVID pathogenesis and therapeutic options is warranted.
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