Malabsorption in Intestinal Scleroderma
Authors: GERALD SALEN
Journal: Annals of Internal Medicine (1966)

Case Studies1 April 1966Malabsorption in Intestinal SclerodermaRelation to Bacterial Flora and Treatment with AntibioticsGERALD SALEN, M.D., FRANZ GOLDSTEIN, M.D., F.A.C.P., C. WILMER WIRTS, M.D., F.A.C.P.GERALD SALEN, M.D.Search for more papers by this author, FRANZ GOLDSTEIN, M.D., F.A.C.P.Search for more papers by this author, C. WILMER WIRTS, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-64-4-834 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptSmall-intestinal involvement in scleroderma has received increasing attention in recent years. Both the radiologic and pathologic features have been described in detail. Segmental dilatation of the jejunum and descending duodenum and delayed intestinal transit are the main radiologic findings (1, 2). Atrophy and fragmentation of the muscular coats with increased deposition of collagen are characteristic histologic features (3, 4); the mucosa is essentially intact (5). Rosson and Yesner (6) recently reported increased deposition of collagen around and between the lobules of Brunner's glands.Despite the relative frequency of small-intestinal involvement in scleroderma (1, 2, 4) only 11 cases have been...References1. HALESCHATZKI CHR: The roentgenological appearance of the gastrointestinal tract in scleroderma. Amer. J. Roentgen. 51: 407, 1944. Google Scholar2. REINHARDTBARRY JFWF: Scleroderma of the small bowel. Amer. J. Roentgen. 88: 687, 1962. Google Scholar3. ABRAMSCARNESEATON HLWHJ: Alimentary tract in disseminated scleroderma with emphasis on small bowel. Arch. Intern. Med. (Chicago) 94: 61, 1954. CrossrefGoogle Scholar4. HEINZSTEINBERGSACKNER ERAJMA: Roentgenographic and pathologic aspects of intestinal scleroderma. Ann. Intern. Med. 59: 822, 1963. LinkGoogle Scholar5. MCBRIENLOCKHART-MUMMERY DJHE: Steatorrhea in progressive systemic sclerosis (scleroderma). Brit. Med. J. 2: 1653, 1962. CrossrefMedlineGoogle Scholar6. ROSSONYESNER RSR: Peroral duodenal biopsy in progressive systemic sclerosis. New Eng. J. Med. 272: 391, 1965. CrossrefMedlineGoogle Scholar7. ROSENTHAL FD: Small intestinal lesions with steatorrhea in diffuse systemic sclerosis (scleroderma). Gastroenterology 32: 332, 1957. CrossrefMedlineGoogle Scholar8. HORSWELLHARGROVEPEETERUFFIN RRMDWPJM: Scleroderma presenting as the malabsorption syndrome. A case report. Gastroenterology 40: 580, 1961. CrossrefMedlineGoogle Scholar9. HOSKINSNORRISGOTTLIEBZAMCHECK LCHTLSN: Functional and morphologic alterations of the gastrointestinal tract in progressive systemic sclerosis (scleroderma). Amer. J. Med. 33: 459, 1962. CrossrefMedlineGoogle Scholar10. SONNEVELDTVAN LEEUWENBLOM HAPPS: Malabsorption in aerosclerosis. Disseminated scleroderma. Acta. Med. Scand. 171: 391, 1962. CrossrefMedlineGoogle Scholar11. SOMMERVILLEBARGENPUGH RLJADG: Scleroderma of the small intestine. Postgrad. Med. 26: 356, 1959. CrossrefMedlineGoogle Scholar12. SHERWOODGOLDSTEINHAURANIWIRTS WCFFICW: Studies of the small-intestinal bacterial flora and of intestinal absorption in pernicious anemia. Amer. J. Dig. Dis. 9: 416, 1964. CrossrefMedlineGoogle Scholar13. VAN DE KAMERTEN BOKKEL HUININKWEYERS JHHHA: Rapid method for determination of fat in the feces. J. Biol. Chem. 177: 347, 1949. CrossrefMedlineGoogle Scholar14. CHRISTIANSENKIRSNERABLAZA PAJBJ: D-xylose and its use in the diagnosis of malabsorptive states. Amer. J. Med. 27: 443, 1959. CrossrefMedlineGoogle Scholar15. MARSHALL I: Collagen disease of the small bowel. New Eng. J. Med. 255: 978, 1956. CrossrefMedlineGoogle Scholar16. CREGANHAYWARD JNJ: The bacterial content of the healthy human small intestine. Brit. Med. J. 1: 1356, 1953. CrossrefMedlineGoogle Scholar17. GOLDSTEINWIRTSJOSEPHS FCWL: The bacterial flora of the small intestine (abstract). Gastroenterology 42: 755, 1962. Google Scholar18. DONALDSON RM: Normal bacterial populations of the intestine and their relation to intestinal function. New Eng. J. Med. 270: 1050, 1964. CrossrefMedlineGoogle Scholar19. GOLDSTEINCOZZOLINOWIRTS FHJCW: Diarrhea and steatorrhea due to a large solitary duodenal diverticulum. Report of a case. Amer. J. Dig. Dis. 8: 937, 1963. CrossrefMedlineGoogle Scholar20. KAHNJEFFRIESSLEISENGER IJGHMH: The effect of antibiotics on the malabsorption of scleroderma (abstract). Gastroenterology 48: 825, 1965. Google Scholar21. DONALDSON RM: Malabsorption of Co60-labeled cyanocobalamin in rats with intestinal diverticula. 1. Evaluation of possible mechanisms. Gastroenterology 43: 271, 1962. CrossrefMedlineGoogle Scholar22. GOLDSTEINCRIDENJENNERWIRTS FLEERCW: Bacterial utilization of dxylose (abstract). Gastroenterology 48: 818, 1965. Google Scholar23. PAULKFARRAR EAWE: Diverticulosis of the small intestine and megaloblastic anemia. Amer. J. Med. 37: 473, 1964. CrossrefMedlineGoogle Scholar24. DUBOSSCHAEDLERCOSTELLOHOET RRWRP: Indigenous, normal, and autochthonous flora of the gastrointestinal tract. J. Exp. Med. 122: 67, 1965. CrossrefMedlineGoogle Scholar25. SCHAEDLERDUBOSCOSTELLO RWRR: Association of germfree mice with bacteria isolated from normal mice. Ibid., p. 77. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Philadelphia, PennsylvaniaFrom the Division of Gastroenterology, Department of Medicine, Jefferson Medical College, Philadelphia, Pa.This work was supported by research grants AM 02804-06 and AM 09141-01, the Institute of Arthritis and Metabolic Diseases, and clinical research grant FR 72, from the National Institutes of Health, Bethesda, Md.Dr. Salen was a fellow of the American Cancer Society from 1964 to 1965 and a National Institutes of Health research fellow from 1965 to 1966, supported by grant F2 AM-28, 395-01.Requests for reprints should be addressed to Franz Goldstein, M.D., Jefferson Medical College, 1025 Walnut St., Philadelphia, Pa. 19107. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByAntibiotic efficacy in small intestinal bacterial overgrowth–related chronic diarrhea: A crossover, randomized trialMonitoring and antibacterial treatment for postoperative bacterial overgrowth in Crohn's diseaseAtteinte de l'intestin grêle au cours de la sclérodermie systémiqueGASTROINTESTINAL MANIFESTATIONS OF SCLERODERMAGASTROINTESTINAL MANIFESTATIONS OF SCLERODERMAGastrointestinal manifestations of systemic sclerosisGastrointestinal involvement in systemic sclerosisGastrobiliary motility after liquid fatty meal in progressive systemic sclerosisReduced Accuracy of 14 C-D-Xylose Breath Test for Detecting Bacterial Overgrowth in Gastrointestinal Motility DisordersDiarrhoea in the elderly: epidemiological and aetiological factorsSouthwestern Internal Medicine Conference: Clinical Features, Pathogenic Mechanisms, and New Developments in the Treatment of Systemic SclerosisAlterations of small intestine motility by bacteria and their enterotoxinsHome central venous hyperalimentation in fifteen patients with severe scleroderma bowel diseaseMaladie cœliaque et malabsorptionsCeliac disease and malabsorptionMotility Malfunction of the Gastrointestinal Tract by Rare Diseases — Fibrosis of the Intestinal WallULTRASTRUCTURE OF THE SMALL INTESTINAL MUCOSA IN PROGRESSIVE SYSTEMIC SCLEROSIS (PSS)Intestinal involvement in progressive systemic sclerosis detected by increased unconjugated serum bile acids.Gastrointestinal function in patients with progressive systemic sclerosisReview: Pathophysiology of Diarrhea Caused by Bacterial Overgrowth of the Small IntestineAltered motility and duration of bacterial overgrowth in experimental blind loop syndromeBakterienflora des DünndarmsGastrointestinal manifestations of sclerodermaIntestinal MicrofloraIIeal dysfunction and bacterial overgrowth in patients with Crohn's diseaseThe gastrointestinal manifestations of scleroderma: Pathogenesis and managementSmall intestinal structure and passive permeability in systemic sclerosis.Small intestinal bacterial growth in systemic sclerosisSmall Intestine Bacterial OvergrowthProgressive Systemic Sclerosis: Gastrointestinal InvolvementBile Salt Metabolism:II. Bile Salts and DiseaseSjögren's Syndrome in Progressive Systemic SclerosisJAMES F. CIPOLETTI, M.D., ROBERT B. BUCKINGHAM, M.D., F.A.C.P., E. LEON BARNES, M.D., ROBERT L. PEEL, M.D., KHALID MAHMOOD, M.D., FRANKLIN E. CIGNETTI, M.D., JOHN M. PIERCE, M.D., BRUCE S. RABIN, M.D., GERALD P. RODNAN, M.D., F.A.C.P.Die intestinale Resorption von Digoxin bei Patienten mit progressiver SklerodermieSclerosis of the intestinal tract with severe malabsorptionThe esophageal and small-bowel manifestations of progressive systemic sclerosisScleroderma (Progressive Systemic Sclerosis) with Severe Bowel Involvement. Treatment by Extensive Resection of the Small IntestineDer Tryptophan-Stoffwechsel bei der progressiven SklerodermieDas PeritoneumDuodenal Myoelectric Activity in SclerodermaCase 32-1973The Malabsorption SyndromeIntestinal Flora in Diagnosis of MalabsorptionDifferential Diagnostic Approach to Clinical Problems of MalabsorptionMonosaccharide intolerance and hypoglycemia in infants with diarrbea. I. Clinical course of 23 infantsIntraluminal Small-Intestinal Utilization of d-Xylose by BacteriaInfiltrative diseases of the small bowel and malabsorptionClinical Observations on MalabsorptionSCLERODERMA: 2. INCIDENCE OF SYSTEMIC DISTURBANCE AND ASSESSMENT OF POSSIBLE ÆTIOLOGICAL FACTORSSclerodermatous involvement of the stomach and the small and large bowel.Diverticulosis of the small intestinePathologic observations in systemic sclerosis (scleroderma)Systemic sclerosis and small bowel involvement.Systemic sclerosisIntestinal atony in progressive systemic sclerosis (scleroderma)Case 22-1968Cytology of Intestinal Epithelial CellsPopulation control in the small bowel.Abnormal Bile-Salt Patterns and Intestinal Bacterial Overgrowth Associated with MalabsorptionMalabsorption in rheumatoid arthritis: An unusual complication caused by amyloidosisControl of Malabsorption in Scleroderma*AnnouncementIntestinal Bacteria and MalabsorptionROBERT M. DONALDSON JR., M.D. 1 April 1966Volume 64, Issue 4Page: 834-841KeywordsEscherichia coliExcretionIngestionJejunumMetabolic disordersMucous membranesOral administrationPathogenesisResearch grantsScleroderma Issue Published: 1 April 1966 PDF DownloadLoading ...