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Health Dictionary

Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Tropical sprue laboratory findings

Introduction

Overview

Overview

Tropical sprue is a diagnosis of exclusion and there are no specific laboratory findings. Blood smear will show megaloblastic changes in chronic phase of tropical sprue. All the etiologies of malabsorption must be ruled out to consider the diagnosis of tropical sprue.

Laboratory Findings

Laboratory Findings

Tropical sprue is diagnosed based on the following criteria:[1]

All the patients with celiac disease unresponsive to gluten free diet, a diagnosis of tropical sprue must be considered. The lab findings are not specific for tropical sprue as it is a diagnosis of exclusion. [2]

Approach to a Patient With Malabsorption in Tropical Region

 
 
 
 
 
 
 
 
 
 
 
 
 
 
Clinical suspicion of malabsorption syndrome
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Initial screening perform:
•Stool microscopy to rule out infectious causes
•D-xylose test to test for the presence of intestinal enterocyte dysfunction
•Fecal fat test for detection of steatorrhea
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
If D-Xylose and feacal fat tests are positive, confirmatory tests for malabsoption should be done
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
•Positive antiendomysial antibodies and villous atrophy suggests celiac disease
•Positive breath hydrogen test suggests lactase deficiency
•Positive microscopy and culture of jejunal aspirate suggests small bowel bacterial overgrowth
•Low serum immunoglobulin suggests B-cell deficiency
•HIV serology for HIV infection
•CT enterography to rule out intestinal inflammatory conditions
•Abdomen CT to rule out chronic pancreatitis
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Once other possibilities are ruled out, suspect diagnosis of tropical sprue
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Start tetracycline therapy
Improvement of symptoms with tetracycline confirms the diagnosis
 

Laboratory Investigations in Patient with Malabsorption

References

References

  1. ↑ Walker MM (2003). “What is tropical sprue?”. J Gastroenterol Hepatol. 18 (8): 887–90. PMID 12859716.
  2. ↑ Bonnefoy S, Chauvin A, Galéano-Cassaz C, Camilleri-Broet S, Jacquet SF, Carmoi T; et al. (2012). “[Tropical sprue in an expatriate]”. Rev Med Interne. 33 (5): 284–7. doi:10.1016/j.revmed.2012.01.015. PMID 22405324.
  3. ↑ Misra RC, Kasthuri D, Chuttani HK (1967). “Correlation of clinical, biochemical, radiological, and histological findings in tropical sprue”. J Trop Med Hyg. 70 (1): 6–10. PMID 6016817.
  4. ↑ Thomas P, Forbes A, Green J, Howdle P, Long R, Playford R, Sheridan M, Stevens R, Valori R, Walters J, Addison G, Hill P, Brydon G (2003). “Guidelines for the investigation of chronic diarrhoea, 2nd edition”. Gut. 52 Suppl 5: v1–15. PMID 12801941.[1].

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]; Associate Editor(s)-in-Chief: Aravind Kuchkuntla, M.B.B.S[3]