Related Experiment Videos
[Giardiasis in children with chronic diarrhea. Incidence, growth, clinical symptoms and changes in the small
K Hjelt1, A Paerregaard, P A Krasilnikoff
1Børneafdelingen, Københavns Amts Sygehus i Gentofte.
Insights
Giardiasis in children causes chronic diarrhea, leading to significant growth impairment and small intestinal damage. Early diagnosis and intervention are crucial for recovery and growth catch-up.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
Context:
- Giardiasis is a common parasitic infection affecting children globally.
- Chronic diarrhea in children can lead to significant health complications, including malnutrition and growth faltering.
Purpose:
- To investigate the clinical presentation, diagnostic findings, and outcomes of giardiasis in children with chronic diarrhea.
- To assess the impact of giardiasis on small intestinal mucosa and nutrient absorption.
Summary:
- A six-year study of 29 children with chronic diarrhea due to giardiasis revealed significant growth deceleration and small intestinal mucosal abnormalities in a majority of cases.
- D-xylose and lactose malabsorption were observed in 25% of patients, correlating with the degree of mucosal damage.
- Persistent diarrhea was associated with younger age, shorter illness duration, and more significant weight loss, with a more severe course noted in children infected abroad.
Impact:
- Highlights the potential for severe gastrointestinal and nutritional consequences of giardiasis in pediatric populations.
- Underscores the importance of considering giardiasis in the differential diagnosis of chronic diarrhea in children, especially those with a history of international travel.
Abstract:
During a six-year period, 29 children (aged 0.7-13.5 years, mean 3.3 years) suffering from chronic diarrhoea due to giardiasis were studied. The incidence of this illness was 81 per 1,000,000 per year among children aged 0- < 7 years. According to growth charts, relative height and weight of the patients decreased significantly (both approximately 0.5 SD) from before the onset of diarrhoea to the time of diagnosis and subsequently increased up to the end of catch-up growth. Small intestinal mucosal specimens were studied. Two patients had severe villous atrophy, 8 moderate abnormalities, 6 only slight changes and 13 biopsies were normal. D-xylose or lactose malabsorption was detected in 25% of the patients. The lactose malabsorption was due to hereditary low lactase levels. None of the patients with a Danish ethnic background showed lactose malabsorption. D-xylose absorption and the relative weight loss of the patients correlated with the degree of mucosal damage. Patients with persistent diarrhoea (n = 19) were younger and had a shorter duration of diarrhoeal illness and a more significant weight reduction than those with intermittent diarrhoea (n = 10). However, the age at onset of symptoms was similar in the two groups (medians 1.3 years). Seven patients contracted the disease abroad. They all developed persistent diarrhoea and had a more severe course of the illness than those who acquired the disease in Denmark.