1/5. Multifocal small bowel lymphoma and latent celiac sprue.Malignant small intestinal lymphoma may complicate or antedate clinical recognition of celiac sprue, a disorder becoming increasingly diagnosed as a subclinical or occult disease. A 73-yr-old woman with previously resected jejunoileal lymphoma and normal proximal small bowel biopsy specimens was given a high-gluten diet containing 40 g of added gluten daily for 4 wk. This caused small intestinal biopsy abnormalities typical of celiac sprue; the abnormalities resolved 6 wk later with a gluten-free diet. This indicates that latent celiac sprue may be present in some patients with lymphoma and suggests that the association of celiac sprue and lymphoma may be more frequent than is currently appreciated.- - - - - - - - - - ranking = 1keywords = sprue (Clic here for more details about this article) |
2/5. Idiopathic chronic ulcerative enteritis: a report of two cases.Idiopathic chronic ulcerative enteritis (ICUE) is considered by some physicians to be a variant of sprue. Two patients being treated at our hospital for nonspecific abdominal symptoms had abnormal findings from a small-bowel series; at surgery, an ulcerating process involving the jejunum was found. Clinical, radiological, and pathological findings in these cases suggest that ICUE is a distinct entity.- - - - - - - - - - ranking = 0.125keywords = sprue (Clic here for more details about this article) |
3/5. Recurrent colonic ulcers in celiac sprue, an unrecognized fatal complication: report of a case.In a patient who had celic sprue intractable to a gluten-free diet, volvulus and jejunal and colonic ulcers developed. Following segmental colonic resection, these ulcers recurred at the site of the previous anastomosis, and proved a fatal complication because of colonic perforation. Since no obvious etiology of colonic ulcers could be identified in this case, it is possible that they may represent an unrecognized intestinal complication of celiac sprue similar to jejunoileal ulcers.- - - - - - - - - - ranking = 0.75keywords = sprue (Clic here for more details about this article) |
4/5. Use of azathioprine for nongranulomatous ulcerative jejunoileitis.Nongranulomatous ulcerative jejunoileitis (NGUJI) is a rare, often fatal disorder that produces multiple nonmalignant small bowel ulcerations. A 55-year-old woman with presumed celiac disease presented with steroid-refractory diarrhea, weight loss and abdominal pain. A laparotomy was performed to exclude the possibility of a lymphomatous disorder, and multiple nonmalignant small bowel ulcerations were discovered. Despite a combination of treatment with total parenteral nutrition (TPN) and prednisone 30 mg/day she continued to deteriorate. The addition of azathioprine to her treatment regimen resulted in marked clinical and biochemical improvement. Her enteroscopy normalized, and she was able to discontinue TPN and reduce her steroid requirements. Although azathioprine has been used occasionally to treat refractory sprue, there have been no reports of its use in NGUJI. In this case, azathioprine played a key role in the management of NGUJI and should be considered a treatment option for patients with this disorder.- - - - - - - - - - ranking = 0.125keywords = sprue (Clic here for more details about this article) |
5/5. Colonic volvulus and ulcerative jejunoileitis due to occult celiac sprue.Colonic volvulus is a rare complication of celiac disease. A case is reported of a 46-year-old man with a long-standing history of diarrhea and abdominal distention with a diagnosis of irritable bowel syndrome. After an elective inguinal hernia repair, a cecal volvulus and an ulcerative jejunoileitis developed in the patient that required an extensive intestinal resection. short bowel syndrome developed and was treated with total parenteral and enteral nutrition. The patient had a poor course after reinitiation of oral diet. Subsequently, celiac sprue was diagnosed and the patient improved with a gluten-free diet.- - - - - - - - - - ranking = 0.625keywords = sprue (Clic here for more details about this article) |