Definition
Tropical sprue is a disease characterized by malabsorption and megaloblastic anemia. It occurs mainly in south-eastern Asia, southern India and the Caribbean, affecting both the indigenous population and tourists.
Although the etiology of the tropical sprue is unclear, it is believed to be due to a chronic intestinal infection. Furthermore, it was found that tropical sprue is rarely found in visitors who stay for less than a month in areas where the disease is endemic.
Most common symptoms and signs *
- Oral aphthosis
- Megaloblastic anemia
- Anorexia
- Asthenia
- Abdominal cramps
- Diarrhea
- Yellow Diarrhea
- Dehydration
- Dysentery
- Abdominal distention
- Abdominal pain
- Edema
- Ease of bleeding and bruising
- Temperature
- Swollen legs
- Glossitis
- Abdominal swelling
- undernourishment
- hypovitaminosis
- macrocytosis
- Nausea
- Weight loss
- Swollen and tired feet
- Fatigue with spasms (spasmophilia)
- steatorrhea
- Constipation
Further indications
The tropical sprue causes chronic inflammation of the intestine, with malabsorption, watery diarrhea, abdominal distention, fever and general malaise. A chronic phase follows, characterized by milder diarrheal discharges, nausea, loss of appetite, abdominal cramps and fatigue. Steatorrhea is frequent.
Nutritional deficiencies, especially folic acid and vitamin B12, cause megaloblastic anemia after several months. The patient may also present weight loss, coagulation changes, glossitis, stomatitis and peripheral edema.
The diagnosis of tropical sprue is placed on a clinical basis. Confirmation is obtained by endoscopy of the gastrointestinal tract associated with biopsy. This investigation, in fact, allows to find characteristic histological alterations of the small intestine, such as the reduction of villi and the infiltration of inflammatory cells in the epithelium and lamina propria. Further laboratory tests (eg blood count and dosage of albumin, calcium, iron, folic acid and vitamin B12) are useful in assessing the nutritional status of the patient.
The treatment consists of the administration of tetracyclines and folates. Other nutritional supplements are administered only when necessary.
