Cases reported "Malabsorption Syndromes"

Filter by keywords:



Filtering documents. Please wait...

11/83. purpura fulminans due to streptococcus pneumoniae sepsis following gastric bypass.

    An older female underwent bariatric surgery which was followed by a significant weight loss and diarrhea, from which C. difficile was isolated just before her hospitalization. Less than 48 hours after admission, she became febrile, developed deep venous thrombosis of the leg and a pulmonary embolus. blood cultures grew out streptococcus pneumoniae and the patient developed purpura fulminans. There was convincing laboratory evidence for disseminated intravascular coagulation and a marked depletion of proteins C and S as well as antithrombin. Treatment with ceftriaxone and drotrecogin alfa together with parenteral nutrition led to disappearance of the pathogen and ultimate normalization of the anticoagulant factors. We believe that malabsorption of vitamin k dependent proteins C, S and antithrombin due to bariatric surgery predisposed the patient to purpura fulminans and disseminated intravascular coagulation.
- - - - - - - - - -
ranking = 1
keywords = nutrition
(Clic here for more details about this article)

12/83. Small intestinal complications in progressive systemic sclerosis.

    A case report of a 33-year-old woman with progressive systemic sclerosis and polymyositis is presented. Admitted with a beta-hemolytic Streptococcus infection of the right knee joint, she had progressive systemic sclerosis with small intestinal involvement, which is rare. This led to more serious complications, malabsorption, pneumoperitoneum, and pneumatosis cystoides intestinalis, which forced a decision to treat her with home total parenteral nutrition. The diagnostic as well as treatment problems encountered in this patient illustrate the importance of nursing care in the overall management of patients with this disease.
- - - - - - - - - -
ranking = 1
keywords = nutrition
(Clic here for more details about this article)

13/83. enteropathy-associated t-cell lymphoma without a prior diagnosis of coeliac disease: diagnostic dilemmas and management options.

    enteropathy-associated t-cell lymphoma (EATL) ultimately develops in 7-10% of patients with long-standing coeliac disease. In patients without a prior diagnosis of coeliac disease this is a very rare disorder, and the diagnosis in such cases is often difficult and delayed due to the non-specific nature of the symptoms and a very low index of clinical suspicion. Standard anti-lymphoma therapies have minimal utility in patients with EATL, and their prognosis is poor. An added difficulty is the high risk of intestinal perforation especially with the commencement of treatment due to the multifocal nature of bowel disease and poor underlying nutrition and tissue integrity. To illustrate these problems and provide an example of how these issues may be addressed, we report the case of a patient with EATL who was completely asymptomatic from unsuspected underlying coeliac disease and presented initially with back pain followed by bowel obstruction. He was treated with gut rest with total parenteral nutrition before commencing an intensive chemotherapy regimen [hyper-CVAD (cyclophosphamide, vincristine, doxorubicin, and dexamethasone)] and is currently well in ongoing complete remission 34 months later.
- - - - - - - - - -
ranking = 2
keywords = nutrition
(Clic here for more details about this article)

14/83. Congenital short bowel syndrome with malrotation.

    Congenital short bowel syndrome (SBS) associated with malrotation and malabsorption is a very rare condition. We report on an infant girl with congenital SBS associated with malrotation and malabsorption. No polyhydraminos was noted during the regular prenatal examination. Protracted postnatal postprandial vomiting with progressive failure to thrive was noted. A laparotomy showed the small bowel was only about 20 cm in length. She eventually survived with short-term parenteral nutrition and use of oral L-glutamine supplementation. To our knowledge, this might be the shortest length of bowel loop ever reported. Currently, she is 15 months of age with a body weight of about 7 kg and good development.
- - - - - - - - - -
ranking = 1
keywords = nutrition
(Clic here for more details about this article)

15/83. hypoparathyroidism and co-existing celiac disease.

    A 62-yr-old woman with idiopathic hypoparathyroidism was admitted to our hospital for severe anemia (Hb 5.6 gr/dl) and hypoalbuminemia (3.2 gr/dl). hypoparathyroidism was diagnosed when she was 33 yr old, because of repeated hypocalcemic tetanic crises, low calcium and high phosphate levels. Since then she has been treated with oral calcium gluconate and calcitriol, with satisfactory clinical balance and normalization of calcium serum levels. After menopause, despite this therapy, the patient still had frequent hypocalcemic tetanic crises, resolving with iv administration, in high doses, of calcium gluconate. The anemia, for which the patient came to our attention, was hypochromic microcytic and in the past she had been treated with iron and transfusion therapy. The patient's recent history also revealed recurrent long lasting episodes of diarrhea, hyporexia and weight loss. The clinical presentation seemed related to a malabsorption syndrome: a celiac disease (CD) diagnosis was confirmed, based upon the finding, at duodenal biopsy, of a severe villous atrophy. A bone mineral density (BMD) evaluation showed a limited reduction of femoral values classified as osteopenia according to the world health organization (WHO) criteria. Thereafter, the patient was instructed to follow a gluten-free diet which rapidly led to an improvement of the nutritional parameters and to a reduction of calcium and vitamin d requirements. Difficult clinical and metabolic control in hypoparathyroidism patients may suggest the possible co-existence of both endocrine and extra-endocrine autoimmune diseases, such as CD. Moreover, bone density, normally reduced in celiac patients, seems to be preserved (maintained) by the lack of parathyroid secretion.
- - - - - - - - - -
ranking = 1
keywords = nutrition
(Clic here for more details about this article)

16/83. Two newborns with nutritional vitamin B12 deficiency: challenges in newborn screening for vitamin B12 deficiency.

    Vitamin B12 deficiency causes decreased methionine Synthase and L-methylmalonyl-coa mutase activity and results in accumulation of homocysteine, methylmalonic acid and Propionylcarnitine. Propionylcarnitine is included in tandem mass spectrometry-based newborn screening programs for detection of certain inborn errors of metabolism. We report two asymptomatic newborns with Vitamin B12 deficiency due to maternal deficiencies. One was detected incidentally at 3 weeks of age; the second on supplemental newborn screening based on elevated Propionylcarnitine at 2 days of age. This illustrates the potential for false negative results for Vitamin B12 deficiency screening by acylcarnitine profiling in newborn screening. homocysteine and methylmalonic acid may be better markers of Vitamin B12 deficiency. In conclusion, we suggest measuring methylmalonic acid, Propionylcarnitine and homocysteine levels in blood spots in expanded newborn screening in order to detect asymptomatic newborns with Vitamin B12 deficiency. Further studies are needed to establish the sensitivity of these three markers in screening for Vitamin B12 deficiency.
- - - - - - - - - -
ranking = 4
keywords = nutrition
(Clic here for more details about this article)

17/83. Brown bowel syndrome: case report and review.

    Brown bowel syndrome is characterized by deposits of lipofuscin in the tunica muscularis of the small intestine. Its etiology is associated with chronic malabsorption resulting in a deficiency of vitamin e. This hypovitaminosis is believed to cause a mitochondrial myopathy secondary to loss of the antioxidant properties of vitamin e, which further worsens the malabsorption and leads to atonic, dilated segments of bowel. Current treatment options involve nutritional supplementation, surgical resection of the affected segments, and intestinal transplantation.
- - - - - - - - - -
ranking = 1
keywords = nutrition
(Clic here for more details about this article)

18/83. Successful small-bowel/liver transplantation.

    A patient with the short-gut syndrome and antithrombin iii deficiency underwent small bowel and liver grafting a year ago. Transient, mild graft-versus-host disease and intestinal rejection occurred within 2 months of grafting and were easily managed. parenteral nutrition was discontinued 8 weeks after surgery. The patient has maintained normal nutritional indices while on an unrestricted oral diet. Small-bowel/liver grafting is feasible for patients with the short-gut syndrome and associated liver disorders. Further experience is needed to determine the specific risks, benefits, and general applicability of this procedure.
- - - - - - - - - -
ranking = 2
keywords = nutrition
(Clic here for more details about this article)

19/83. Surgical techniques in short bowel syndrome.

    An operation according to Bianchi in a 2-year-old girl is described and indications as well as technical procedure are discussed. The girl was born with a gastroschisis. There was a jejunal perforation 10 cm below the ligament of Treitz caused by a volvulus. Only 20 cm of the jejunum remained. Moreover, only the left part of the colon was present. Total parenteral nutrition for 2 years was necessary. The principle of the operation is based on a longitudinal division of the remaining bowel and a creation of two separate bowel tubes out of the divided bowel halves, thus effecting an isoperistaltic serial connection by means of two anastomoses. This is technically possible since each half of the bowel wall has its own blood supply. The vessels originating from the mesenterium branch off before they reach the bowel wall so that the mesenteric dissection line can be anastomosed longitudinally with the antimesenteric border. This results in doubling of the bowel length, narrowing of the preoperatively dilated bowel diameter, closer contact of bowel contents with the mucosa, prolonged transit time and a bacteroides colonization which is reduced by more effective peristalsis. Indications, time of operation and our own experiences are discussed and three cases are described. All children are alive and show marked improvement in nutrition.
- - - - - - - - - -
ranking = 2
keywords = nutrition
(Clic here for more details about this article)

20/83. Small bowel transplantation: report of a clinical case.

    Extensive small bowel resection may become necessary for several reasons in children and adults. The only causal therapy of short bowel syndrome is small bowel transplantation. So far severe immunological problems have caused deleterious results despite technically successful transplantation. A clinical case of small bowel transplantation in a child is reported. The 3-year-old boy had been operated on for volvulus which had led to nearly total gangrene of the whole small bowel. Finally, only 4 cm of jejunum could be saved. Total parenteral nutrition (TPN) therefore became necessary. Small bowel transplantation was carried out with the mother as donor; transplantation technique is described in detail. Postoperative immunosuppression was performed by administration of cyclosporin A and prednisolone. Because of graft rejection, the graft had to be removed on the 12th postoperative day. At present, the child is well and on TPN again. This case shows that small bowel transplantation by living related organ donation is technically possible without impairment of the donor's quality of life. Further experimental and clinical work should be encouraged.
- - - - - - - - - -
ranking = 1
keywords = nutrition
(Clic here for more details about this article)
<- Previous || Next ->


Leave a message about 'Malabsorption Syndromes'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.