Severe Histopathological Lesion of Sprue in Patient with Minimal Evidence of Malabsorption
Authors: I. MICHAEL SAMLOFF
Journal: Annals of Internal Medicine (1964)

Case Studies1 April 1964Severe Histopathological Lesion of Sprue in Patient with Minimal Evidence of MalabsorptionSerial Jejunal Biopsy and Clinical ObservationsI. MICHAEL SAMLOFF, M.D., MAURICE L. KELLEY, M.D., F.A.C.P., VICTOR W. LOGAN, M.D., F.A.C.P., ROGER TERRY, M.D.I. MICHAEL SAMLOFF, M.D.Search for more papers by this author, MAURICE L. KELLEY, M.D., F.A.C.P.Search for more papers by this author, VICTOR W. LOGAN, M.D., F.A.C.P.Search for more papers by this author, ROGER TERRY, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-60-4-673 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptBasic understanding of the disorder known as celiac disease or nontropical sprue, has increased in recent years largely due to the recognition of characteristic histopathological abnormalities in the intestinal mucosa obtained by peroral biopsy and the realization that exclusion of gluten from the diet frequently produces a clinical remission.We feel it is worth-while to call attention to the patient described in this report to demonstrate and emphasize the following points.1. Severe histopathological changes in jejunum may exist with negligible derangement of the established tests of intestinal absorption.2. Peroral biopsy in this situation is the only means of...References1. RUBINBRANDBORGPHELPSTAYLOR CELLPCHC: Studies of celiac disease. I. The apparent identical and specific nature of the duodenal and proximal jejunal lesion in celiac disease and idiopathic sprue. Gastroenterology 38: 28, 1960. CrossrefMedlineGoogle Scholar2. RUBIN CE: Celiac disease and idiopathic sprue. Some reflections on reversability, gluten and the intestine. Gastroenterology 39: 260, 1960. MedlineGoogle Scholar3. GALEN EH: Nontropical sprue: reversal of proximal jejunal lesion in a patient treated with a gluten free diet. Gastroenterology 43: 465, 1962. CrossrefMedlineGoogle Scholar4. SHINERDONIACH MI: Histopathologic studies in steatorrhea. Gastroenterology 38: 419: 1960. CrossrefMedlineGoogle Scholar5. RUBINBRANDBORGPHELPSTAYLORMURRAYSTEMLERHOWRYVOLWILER CELLPCHCCVRCW: Studies of celiac disease. II. The apparent irreversability of the proximal intestinal pathology in celiac disease. Ibid., p. 517. Google Scholar6. PADYKULASTRAUSSLADMANGARDNER HAEWAJFH: A morphologic and histochemical analysis of human jejunal epithelium in nontropical sprue. Gastroenterology 40: 735, 1961. CrossrefMedlineGoogle Scholar7. RUBINBRANDBORGFLICKPARMENTIERPHELPSVAN NIEL CELLALCPS: The effect of wheat instillation into the proximal ileum of patients with idiopathic sprue. J. Clin. Invest. 39: 1023, 1960. Google Scholar8. YARDLEYBAYLESSNORTONHENDRIX JHTMJHTR: Celiac disease: a study of the jejunal epithelium before and after a gluten-free diet. New Eng. J. Med. 267: 1173, 1962. CrossrefMedlineGoogle Scholar9. BOSSAKWANGADLERSBERG ETCID: Clinical aspects of the malabsorption syndrome, in The Malabsorption Syndrome, edited by ADLERSBERG, D., Grune & Stratton, New York, 1957, pp. 112-129. Google Scholar10. GRANT JM: Studies on celiac disease. I. The interrelationship between gliadin, psychological factors and symptom formation. Psychosom. Med. 21: 439, 1959. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Rochester, New YorkFrom the Departments of Medicine and Pathology of the University of Rochester School of Medicine and Dentistry, Rochester, New York.This work was supported in part by research grant A-4097 from the National Institute of Arthritis and Metabolic Diseases, National Institutes of Health, United States Public Health Service, Bethesda, Maryland.Requests for reprints should be addressed to I. Michael Samloff, M.D., University of Rochester School of Medicine and Dentistry, Strong Memorial Hospital, 260 Crittenden Boulevard, Rochester 20, New York. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByConventional malabsorption tests: Do they detect the adult patient with villous atrophy?The Clinical PresentationThe effect on jejunal mucosa of withdrawing and adding dietary gluten in cases of idiopathic steatorrhoeaThe subtle and variable clinical expressions of gluten-induced enteropathy (adult celiac disease, nontropical sprue)A Case of Coexisting Duodenal Ulceration and Idiopathic SteatorrheaA Clinical and Histochemical Study of Celiac Disease Before and During a Gluten-Free Diet 1 April 1964Volume 60, Issue 4Page: 673-679KeywordsBiopsyDietGlutenJejunumLesionsMedical servicesMetabolic disordersMucous membranesPrevention, policy, and public healthResearch grants Issue Published: 1 April 1964 PDF DownloadLoading ...