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2.1
Chronic Diarrhea with Villous Atrophy

Presentation

Part II presents studies on Intestinal mucosal immunology. Part III examines the epidemiological relationship between malnutrition and chronic diarrhea in infants and children. [books.google.com]

Background and aim : Both the clinical presentation and the degree of mucosal damage in celiac disease vary greatly. [glutenfreeworks.com]

We noticed a similar therapeutic response in the present case. [omicsonline.org]

Most patients present with occipital epileptic seizures, the course being highly variable, with benign, drug-resistant, or epileptic encephalopathy forms. [orpha.net]

Clinical presentation: Tropical sprue presents with diarrhea, anorexia, weight loss, and megaloblastic anemia. Remissions and relapses are a characteristic feature. In severe cases 10 stools or more may be passed daily. [histopathology-india.net]

Workup

The next month, she was hospitalized a fourth time for nausea, weight loss, and orthostatic hypotension despite her extensive workup. [consultant360.com]

The initial workup of persistent travelers’ diarrhea should always include a C. difficile stool toxin assay. [wwwnc.cdc.gov]

Persistent abnormalities warrant further workup. [mdmag.com]

The immunological workup included analyses of lymphocyte populations with T- and B-cell-specific antibodies, lymphocyte markers, blastogenesis, and immunoglobulin levels. [saudijgastro.com]

HLA-DQ2/DQ8 testing should be performed prior to embarking on a formal gluten challenge as a negative result will obviate the need for further workup. [gi.org]

Treatment

Hammer has assembled a international list of authors who fully update the topic of chronic diarrhea, from examining the causes of diarrhea (and the appropriate treatments) to various diagnostic tools. [books.google.com]

Management and treatment CD requires life-long observance of a gluten-free diet (GFD), leading to clinical and histopathological resolution of symptoms. [orpha.net]

Monitoring treatment Treatment is monitored by Symptom improvement - eg, disappearance of anorexia with adequate B12 and folate replacement. Weight gain. Improvement of FBC and biochemical parameters. [patient.info]

Treatment for Gluten Sensitivity The treatment for non-celiac gluten sensitivity is a 100 percent gluten-free diet. [diarrheadietitian.com]

Data Summary Olmesartan medoxomil is an angiotensin II receptor blocker (ARB) that was approved on April 25, 2002, for the treatment of hypertension, alone or with other antihypertensive agents. [fda.gov]

Prognosis

Prognosis Untreated disease runs a chronic, relapsing course. Treatment is associated with a good prognosis. [patient.info]

Prognosis : generally good. Pathogenesis Etiology Viral or Giardial damage to the cells of the villus. Gluten sensitivity results in infiltration of inflammatory cells and villus atrophy. [vetstream.com]

Prognosis Early diagnosis and good compliance of GFD greatly improve outcome. On the contrary, if treatment is delayed, epilepsy may be more severe and epileptic encephalopathy may develop. [orpha.net]

[…] seronegative disease may show histologic changes Intestinal biopsies from the first and second duodenal portion are essential to confirm the diagnosis Genetic testing for histocompatibility antigens (HLA) is never diagnostically significant Prognostic factors Prognosis [pathologyoutlines.com]

For example, we do not yet know the long-term prognosis or progression, if there is one. The good news is that gluten sensitivity does not seem to affect the villi in the intestine, cause malabsorption, or increase risk of other autoimmune diseases. [diarrheadietitian.com]

Etiology

Etiology Etiology of CEC is unclear. It is not known if epilepsy and/or CC are a consequence of CD. CD is an immune auto-inflammatory reaction occurring in predisposed gluten-intolerant individuals. [orpha.net]

However, when symptoms do not improve with gluten avoidance, other etiologies of spruelike enteropathy must be considered. [consultant360.com]

In May 2013, an article describing patients with villous atrophy and negative serologies for celiac disease reported that some patients without definitive etiologies for villous atrophy were characterized as having unclassified sprue. [medpagetoday.com]

Pathogenesis Etiology Viral or Giardial damage to the cells of the villus. Gluten sensitivity results in infiltration of inflammatory cells and villus atrophy. Secondary to inflammation or infiltration of neoplastic cells. [vetstream.com]

Epidemiology

Part III examines the epidemiological relationship between malnutrition and chronic diarrhea in infants and children. Part IV focuses on the diagnosis and dietary and pharmacological management of chronic diarrhea. [books.google.com]

Over the past decade, Jonas Ludvigsson, MD, PhD, a pediatrician and professor of clinical epidemiology at the Karolinska Institutet in Stockholm, established a large population-based database using biopsy results from 28 pathology departments in Sweden [newsroom.cumc.columbia.edu]

Summary Epidemiology CEC was first described in 1992 and fewer than 200 cases have been reported so far. [orpha.net]

Epidemiology Tropical sprue usually occurs in residents of tropical or subtropical climates (less commonly, visitors), most often in developing countries. The condition may not present until after they have left the area. [patient.info]

Epidemiology: Whites (highest incidence in Northern Europeans, particularly Ireland) although celiac sprue has been documented in Asians from India and Pakistan. [ocw.tufts.edu]

Pathophysiology

This section will review the pathophysiology of some of the more common and important causes of diarrhea in these categories. [ocw.tufts.edu]

Discussion: The pathophysiology of olmesartan induced sprue-like enteropathy is only theorized at this point. [shmabstracts.com]

Pathophysiology The villus is the functional unit of the small intestine. There are many hundreds of thousands of these units within the small intestine. They are responsible for final stages of digestion and absorption of food. [vetstream.com]

Objectives After completing this article, readers should be able to: Understand the pathophysiologic mechanisms involved in chronic diarrhea. [pedsinreview.aappublications.org]

[…] intraepithelial lymphocytosis) Partial or total atrophy of intestinal villi and hyperplasia of intestinal crypts with chronic inflammation in the lamina propria Terminology Celiac disease Nontropical sprue Gluten sensitive enteropathy Gluten induced enteropathy Pathophysiology [pathologyoutlines.com]

Prevention

[…] of HIV HIV Transmission and Prevention in Specific Populations Systematic Review of HIV Behavioral Prevention Research in African Americans Lynae A. [hivinsite.ucsf.edu]

So preventing autoimmune disease is one very important reason why early diagnosis and treatment of gluten sensitivity is important. [celiac.com]

Prevention There is no established way to prevent the disease whilst visiting areas of risk. [patient.info]

Raising awareness of possible side effects is critical in avoiding preventable morbidity, mortality and healthcare costs. To cite this abstract: Jalal J, Edwin S, Aung Y, Naik M, Joseph S. [shmabstracts.com]

This prevents the migration of new cells up the villus and consequently failure of the villus and severe villus atrophy. [vetstream.com]

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