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Small intestinal HIV-associated enteropathy: evidence for panintestinal enterocyte dysfunction
S Carlson1, H Yokoo, R M Craig
1Department of Medicine, Northwestern University Medical School, Chicago, IL.
The Journal of Laboratory and Clinical Medicine
|November 1, 1994
Summary
This study investigated absorptive defects in AIDS enteropathy using D-xylose testing and Schilling
Area of Science:
- Gastroenterology
- Infectious Diseases
- Clinical Nutrition
Background:
- AIDS enteropathy is characterized by malabsorption.
- The precise nature and location of absorptive defects remain unclear.
Purpose of the Study:
- To characterize proximal intestinal absorptive defects in patients with AIDS enteropathy.
- To correlate D-xylose absorption kinetics with cobalamin absorption and distal intestinal function.
- To compare duodenal and jejunal biopsy findings.
Main Methods:
- Employed a D-xylose kinetic model to assess proximal absorption.
- Utilized Schilling's test for cobalamin absorption.
- Performed duodenal and jejunal endoscopic aspirations and biopsies.
- Analyzed rate constants for D-xylose absorption (Ka) and nonabsorptive loss (Ko).
Main Results:
- Ten of 12 patients exhibited diminished D-xylose absorption (Ka) or elevated nonabsorptive loss (Ko).
- Eight of 10 patients had abnormal Schilling's test results, indicating cobalamin malabsorption.
- Histological examination revealed minimal differences between duodenal and jejunal biopsy sites.
- Weight loss correlated negatively with D-xylose absorption (Ka) and positively with abnormal Schilling's test results.
Conclusions:
- AIDS enteropathy is associated with significant proximal absorptive defects.
- Cobalamin malabsorption is common in AIDS enteropathy.
- Distal intestinal biopsy provided limited additional diagnostic information compared to proximal sites.