Malabsorption and Jejunitis in American Peace Corps Volunteers in Pakistan
Authors: JOHN LINDENBAUM
Journal: Annals of Internal Medicine (1966)

Article1 December 1966Malabsorption and Jejunitis in American Peace Corps Volunteers in PakistanJOHN LINDENBAUM, M.D., THOMAS H. KENT, M.D., HELMUTH SPRINZ, M.D., F.A.C.P.JOHN LINDENBAUM, M.D., THOMAS H. KENT, M.D., HELMUTH SPRINZ, M.D., F.A.C.P.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-65-6-1201 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTropical sprue, a syndrome of unknown cause characterized by diarrhea, weight loss, malabsorption, and changes in small intestinal morphology, occurs in both native residents and visitors to tropical countries. The syndrome has been frequently described in European and American military personnel stationed in Asia (1, 2) or Puerto Rico (3, 4). During the past year, two cases of severe symptomatic sprue have been observed in Peace Corps Volunteers in East Pakistan, and several cases have been seen among Volunteers in Venezuela (5).Recent studies from Thailand, India, Pakistan, Puerto Rico, and Haiti have shown a high prevalence of malabsorption and...References1. KEELEBOUND KDJP: Sprue in India. Brit. Med. J. 1: 77, 1946. CrossrefMedlineGoogle Scholar2. STEFANINI M: Clinical features and pathogenesis of tropical sprue. Medicine (Balt.) 27: 379, 1948. CrossrefMedlineGoogle Scholar3. GARDNER FH: A malabsorption syndrome in military personnel in Puerto Rico. Arch. Intern. Med. (Chicago) 98: 44, 1956. CrossrefGoogle Scholar4. SHEEHYCOHENWALLACELEGTERS TWWCDKLJ: Tropical sprue in North Americans. JAMA 194: 1069, 1965. CrossrefMedlineGoogle Scholar5. SMITH R: Personal communication. Google Scholar6. SPRINZSRIBHIBHADHGANGAROSABENYAJATIKUNDELHALSTEAD HREJCDS: Biopsy of small bowel of Thai people. With special reference to recovery from Asiatic cholera and an intestinal malabsorption syndrome. Amer. J. Clin. Path. 38: 43, 1962. CrossrefMedlineGoogle Scholar7. BAKERIGNATIUSMATHANVAISHCHACKO SJMVISKCC: Intestinal biopsy in tropical sprue, in Intestinal Biopsy, Ciba Foundation Study Group no. 14, edited by WOLSTENHOLME, G. E. W., CAMERON, M. P. Little, Brown and Co., Boston, 1962, p. 84. Google Scholar8. RUSSELLAZIZAHMEDKENTGANGAROSA PKMANTHEJ: Enteritis and gastritis in young asymptomatic Pakistani men. Amer. J. Dig. Dis. 11: 296, 1966. CrossrefMedlineGoogle Scholar9. LINDENBAUMALAMKENT JAKTH: Subclinical small intestinal disease in East Pakistan. Brit. Med. J. In press. Google Scholar10. ANGELGUERRAMARTINEZPLOUGH CRRJIC: Malabsorption of xylose in Puerto Rico (abstract). Fed. Proc. 22: 550, 1963. Google Scholar11. KLIPSTEINSAMLOFFSCHENK FAIMEA: Tropical sprue in Haiti. Ann. Intern. Med. 64: 575, 1966. LinkGoogle Scholar12. ROERICE JHEW: Photometric method for determination of free pentoses in animal tissues. J. Biol. Chem. 173: 507, 1948. CrossrefMedlineGoogle Scholar13. SCHILLING RF: Intrinsic factor studies. II. The effect of gastric juice on the urinary excretion of radioactivity after the oral administration of radioactive vitamin B12. J. Lab. Clin. Med. 42: 860, 1953. MedlineGoogle Scholar14. VAN DE KAMERBOKKEL HUININKWEYERS JHHHA: Rapid method for the determination of fat in feces. J. Biol. Chem. 177: 347, 1949. CrossrefMedlineGoogle Scholar15. JOVERGORDON ARS: Procedure for quantitative analysis of feces with special reference to fecal fatty acids. J. Lab. Clin. Med. 59: 878, 1962. MedlineGoogle Scholar16. CROSBYKUGLER WHHW: Intraluminal biopsy of the small intestine. Amer. J. Dig. Dis. 2: 236, 1957. CrossrefMedlineGoogle Scholar17. FORDTRANSOERGELINGELFINGER JSKHFJ: Intestinal absorption of D-xylose in man. New Eng. J. Med. 267: 274, 1962. CrossrefMedlineGoogle Scholar18. BOOTHMOLLIN CCDL: The site of absorption of vitamin B12 in man. Lancet 1: 18, 1959. CrossrefMedlineGoogle Scholar19. RONNOV-JESSENHANSEN VJ: The site of absorption of Co58-labelled vitamin B12 in man. An investigation made by intestinal intubation with polyethylene glycol as a marker substance. Blood 25: 224, 1965. MedlineGoogle Scholar20. BOOTHSTEWARTHOLMESBRACKENBURY CCJSRW: Dissecting microscope appearances of intestinal mucosa, in Intestinal Biopsy, Ciba Foundation Study Group no. 14, edited by WOLSTENHOLME, G. E. W., CAMERON, M. P. Little, Brown and Co., Boston, 1962, p. 2. Google Scholar21. SCOTTWILLIAMSCLARK GBMJCG: Comparison of jejunal mucosa in post-gastrectomy states, idiopathic steatorrhoea, and controls using the dissecting microscope and conventional histological methods. Gut 5: 553, 1964. CrossrefMedlineGoogle Scholar22. LEISHMAN AW: Thoughts on sprue. After experience in India. Lancet 2: 813, 1945. CrossrefMedlineGoogle Scholar23. AYREY F: Outbreaks of sprue during the Burma campaign. Trans. Roy. Soc. Trop. Med. Hyg. 41: 377, 1948. CrossrefGoogle Scholar24. BAKERMATHANJOSEPH SJVII: The epidemiology of tropical sprue, in Malabsorption Syndromes, Symposium of the Second World Congress of Gastroenterology. Karger, New York, 1963, p. 4. Google Scholar25. FRENCHGADDIESMITH JMRNM: Tropical sprue. A study of seven cases and their response to combined chemotherapy. Quart. J. Med. 25: 333, 1956. MedlineGoogle Scholar26. SHEEHYPEREZ-SANTIAGO TWE: Antibiotic therapy in tropical sprue. Gastroenterology 41: 208, 1961. CrossrefGoogle Scholar27. KLIPSTEIN FA: Tropical sprue in New York City. Gastroenterology 47: 457, 1964. CrossrefMedlineGoogle Scholar28. GUERRAWHEBYBAYLESS RMSTM: Long-term antibiotic therapy in tropical sprue. Ann. Intern. Med. 63: 619, 1965. LinkGoogle Scholar29. MlLANESCURBELORODRIGUEZKOURISPIES FFAPTD: A note on bacteriological and parasitic studies of the intestinal contents of patients with sprue. Gastroenterology 7: 306, 1946. MedlineGoogle Scholar30. NADELGARDNER HFH: Bacteriological assay of small bowel secretion in tropical sprue. Amer. J. Trop. Med. Hyg. 5: 686, 1956. CrossrefMedlineGoogle Scholar31. BAYLESSGUARDIOLA-ROTGERWHEBY TMAMS: Tropical sprue: viral cultures of rectal swabs. Gastroenterology 51: 32, 1966. CrossrefMedlineGoogle Scholar32. SPRINZKUNDELDAMMINHOROWITZSCHNEIDERFORMAL HDWGJREHSB: The response of the germ-free guinea pig to oral bacterial challenge with Escherichia coli and Shigella flexneri. Amer. J. Path. 39: 681, 1961. MedlineGoogle Scholar33. LINDENBAUM J: Malabsorption during and after recovery from acute intestinal infection. Brit. Med. J. 2: 326, 1965. CrossrefMedlineGoogle Scholar34. LINDENBAUM J: Unpublished observations. Google Scholar35. KENT TH: Staphylococcal enterotoxin gastroenteritis in Rhesus monkeys. Amer. J. Path. 48: 387, 1966. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Dacca, East Pakistan, and Washington, D. C.From the Pakistan-SEATO Cholera Research Laboratory, Dacca, East Pakistan, and the Walter Reed Army Institute of Research, Washington, D. C.This work was supported in part by research agreement 196802 between the National Institutes of Health, Bethesda, Md., and the Pakistan-SEATO Cholera Research Laboratory.Requests for reprints should be addressed to John Lindenbaum, M.D., First Medical Division, Bellevue Hospital, 462 First Ave., New York, N. Y. 10016. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byAcute Bacterial GastroenteritisChildhood stunting and cognitive effects of water and sanitation in IndonesiaDuodenal Microbiota in Stunted Undernourished Children with EnteropathyGrowth velocity in children with Environmental Enteric Dysfunction is associated with specific bacterial and viral taxa of the gastrointestinal tract in Malawian childrenA novel histological index for evaluation of environmental enteric dysfunction identifies geographic-specific features of enteropathy among children with suboptimal growthEnteric Dysfunction, EnvironmentalEnvironmental enteric dysfunction: a review of potential mechanisms, consequences and management strategiesIncreased T Cell Differentiation and Cytolytic Function in Bangladeshi Compared to American ChildrenEnvironmental enteric dysfunction and growthEnvironmental enteric dysfunction and growthCharacterisation of environmental enteropathy biomarkers and associated risk factors in children in the context of a WASH trial in Timor-LesteEnvironmental Enteric Dysfunction: A Case Definition for Intervention TrialsThe Burden of Enteropathy and "Subclinical" InfectionsTropical EnteropathiesBiomarkers of Environmental Enteric Dysfunction: The Good, the Bad, and the UglyBiomarkers of Environmental Enteropathy, Inflammation, Stunting, and Impaired Growth in Children in Northeast BrazilDiarrheal DiseasesPathogenesis - Thoughts from the Front LinePathogenesis — Thoughts from the Front LineNausea, Vomiting, and Noninflammatory DiarrheaTropical SprueEnvironmental Enteric Dysfunction: Pathogenesis, Diagnosis, and Clinical ConsequencesImplications of Acquired Environmental Enteric Dysfunction for Growth and Stunting in Infants and Children Living in Low- and Middle-Income Countries"Barriers" to Child Development and Human Potential: The Case for Including the "Neglected Enteric Protozoa" (NEP) and Other Enteropathy-Associated Pathogens in the NTDsThe impoverished gut—a triple burden of diarrhoea, stunting and chronic diseaseGastrointestinal SymptomsNausea, Vomiting, and Noninflammatory DiarrheaTropical SprueTropical Sprue in Two Foreign Residents, With Evidence of Tropheryma whippelii in One CaseTropical Enteritis: Nutritional Consequences and Connections with the Riddle of CholeraTropical enteropathy: a T-cell-mediated crypt hyperplastic enteropathySmall intestinal mucosal pattern of Myanmar childrenTropical Sprue and Subclinical Enteropathy: A Vision for the NinetiesSmall intestinal permeability to mannitol and lactulose in the three ethnic groups resident in west Birmingham.Tropische Enteropathie und tropische SprueSmall bowel morphology in British Indian and Afro-Caribbean subjects: evidence of tropical enteropathy.Gastrointestinal Biopsy Diagnosis in the Tropics11 Imported gastrointestinal diseases in industrialized nationsSmall intestinal permeability in normal Sudanese subjects: evidence of tropical enteropathyIn malnourished childrenIdiopathic Small Intestinal Disease in the TropicsTropical sprue in travelers and expatriates living abroadFolate malnutrition in tropical diarrhoeasNON-SPECIFIC ILEOJEJUNITIS IN AREQUIPA, PERUTropical enteropathy in Rhodesia.Tropical sprue in american servicemen following return from VietnamPaper malabsorption in AfricaTropical EnteropathyImmunoglobulin-Containing Cells in the Small Intestine in Viral HepatitisSmall intestinal villous pattern and mucosal dynamics in healthy JamaicansIntestinal lymphoma and sprue: A systematic approachD�nndarm-Saugbiopsie im Kindesalter: Technik, Komplikationen, Bedeutung f�r die Diagnose intestinaler ErkrankungenIntestinal MicrofloraRecovery of Small-Intestinal Structure and Function After Residence in the Tropics I. Studies in Peace Corps VolunteersJOHN LINDENBAUM, M.D., CHARLES D. GERSON, M.D., THOMAS H. KENT, M.D.Attempts to modify the intestinal villus architecture in miceRegarding the Definition of Tropical SprueTRANSIENT (REVERSIBLE) MALABSORPTION OF VITAMIN B 12Jejunal morphology of the African in UgandaThe villus architecture of the small intestine in the tropics: A necropsy studyTropical sprue.Current Views on Tropical Sprue and a Comparison to Nontropical SprueDigestive Disease as a National ProblemTropical Sprue—Specific Disease or Extreme of a Spectrum?ARTHUR B. FRENCH, M.D., F.A.C.P.Tropical SprueCorrelation of Jejunal Function and Morphology in Patients with Acute and Chronic Diarrhea in East Pakistan 1 December 1966Volume 65, Issue 6Page: 1201-1209KeywordsArmed forcesCholeraDiarrheaEnteritisResearch laboratoriesWeight loss Issue Published: 1 December 1966 PDF downloadLoading ...