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2010, Number 2

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Rev Hematol Mex 2010; 11 (2)

The Changing Clinical Picture of Tropical Sprue

Maldonado N
Full text How to cite this article

Language: English
References: 8
Page: 91-94
PDF size: 56.09 Kb.


Key words:

Tropical sprue, folic acid, neural tube defects, hyperhomocysteinuria.

ABSTRACT

Tropical sprue is an endemic condition in Puerto Rico, some Caribbean islands and Southeast Asia. It is characterized by diarrhea, poor appetite, weight loss and anemia. In recent years the incidence of tropical sprue has declined and the clinical picture is different. The supplementation of cereals and flours with folic acid for the prevention of neural tube defects in the newborns and to decrease hyperhomocysteinuria has disguised the clinical picture of tropical sprue. The condition can be seen without significant anemia with normal folic acid but low vitamin B12 levels. The pernicious anemia which is indistinguishable from tropical sprue hematologically. We are reporting eight patients with tropical sprue who had normal or high folic acid levels but low or high vitamin B12 levels.


REFERENCES

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  2. Ashford BK. El espru en los trópicos. Bol Asoc Med PR 1923;1:3.

  3. Sheehy TW, Perez Santiago E. Antibiotic therapy in tropical sprue. Gastroenterology 1961;41:208.

  4. Guerra R, Wheby M, Bayless TM. Long term antibiotic therapy in tropical sprue. Ann Int Med 1965;63:619.

  5. Maldonado N, Horta E, Guerra R, Perez Santiago E. Poorly absorbed sulfonamides in the treatment of tropical sprue. Gastroenterology 1969;57:559.

  6. Klipstein FA, Haldeman LV, Corcino JJ, Moore WEC. Enterotoxigenic intestinal bacteria in tropical sprue. Ann Int Med 1973;79:632.

  7. Klipstein FA, Corcino JJ. Seasonal occurrence of overt and subclinical tropical malabsorption in Puerto Rico. Amer J Trop Med and Hyg 1974;23:1189.

  8. Crosby WH. The deadly hookworm: why did the Puerto Ricans die? Arch Int Med 1987;147:577.




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Rev Hematol Mex. 2010;11