1/19. Diffuse cutaneous mastocytosis with bone marrow infiltration in a child: a case report.mastocytosis encompasses a range of disorders characterized by overproliferation and accumulation of tissue mast cells. Mast cell disease is most commonly seen in the skin, but the skeleton, gastrointestinal tract, bone marrow, and central nervous system may also be involved. We present a 10-year-old boy with diffuse cutaneous mastocytosis characterized by disseminated papular, nodular, and infiltrated leathery lesions. The patient presented with chronic diarrhea and malnutrition. Laboratory studies were normal except for an elevated urinary 1-methylhistamine level. The bone marrow aspirate showed a dense mast cell infiltrate confirming systemic involvement.- - - - - - - - - - ranking = 1keywords = malnutrition (Clic here for more details about this article) |
2/19. Enteric bacterial flora and bacterial overgrowth syndrome.Under certain conditions, colonic bacterial flora can colonize the upper small bowel in concentrations sufficient to cause mucosal damage and malabsorption of nutrients, vitamin B12, and fat-soluble vitamins. This situation, known as small bowel bacterial overgrowth syndrome (SBBOS) may be an under-appreciated cause of malnutrition in elderly people. The diagnosis of SBBOS should be considered when patients with known or suspected predisposing conditions have symptoms or findings compatible with this syndrome. However, proof of small bowel bacterial overgrowth requires specialized testing that is not readily available. Moreover, disagreement persists as to how best to test definitively for this disease. Therefore, on a practical level and despite the potential drawbacks of such a decision, SBBOS is usually diagnosed when a compatible syndrome responds to an empirical trial of appropriate oral antibiotics. Improvements on this approach to SBBOS will be built on more widespread access to sensitive, specific, and less cumbersome testing than is currently available.- - - - - - - - - - ranking = 1keywords = malnutrition (Clic here for more details about this article) |
3/19. Explosive campylobacter jejuni diarrhea in immunoproliferative small intestinal disease.campylobacter jejuni is an infrequent cause of self limiting acute diarrheal disease in adults in the Indian subcontinent. We report the occurrence of a life threatening diarrhea due to C jejuni infection in a patient with immunoproliferative small intestinal disease. We postulate that immunosuppression due to malignancy, malnutrition and cancer chemotherapy was responsible for the unusually severe diarrhea.- - - - - - - - - - ranking = 1keywords = malnutrition (Clic here for more details about this article) |
4/19. lymphoma creating colojejunal fistula: report of a case and review of the literature.Malignant fistula of the colon to the small bowel is rare and is most often due to adenocarcinoma. Colonic lymphoma is unusual, representing only 0.5 percent of all colonic malignancies. We report a case of intestinal lymphoma presenting with diarrhea and malnutrition. A colojejunal fistula was discovered during colonoscopy by biopsy of small bowel through a fistula in the sigmoid colon. Celiotomy revealed a 12 cm mass in the sigmoid colon with a fistula to the jejunum. pathology was consistent with T-cell lymphoma. This is a rare entity in a nonimmunocompromised host and has not been described in the English literature.- - - - - - - - - - ranking = 1keywords = malnutrition (Clic here for more details about this article) |
5/19. Colonic involvement in stevens-johnson syndrome.Severe gastrointestinal tract involvement is a rare manifestation of stevens-johnson syndrome (SJS). The case is described of a 17 year old man who developed SJS secondary to phenytoin. In addition to the cutaneous, ocular, and oral mucosal lesions typical of SJS, he also developed persistent, bloody diarrhoea associated with life threatening malnutrition. Serial colonoscopy showed severe and progressive colitis. He was treated with a combination of long term nutritional support, probiotic therapy, and supportive measures. He was eventually discharged from hospital six months after admission when the diarrhoea improved and he began to gain weight.- - - - - - - - - - ranking = 1keywords = malnutrition (Clic here for more details about this article) |
6/19. Enteral hyperalimentation with continuous subcutaneous insulin infusion improved severe diarrhea in poorly controlled diabetic patient.Little is known about effective treatment for severe diarrhea in the insulin-dependent diabetic patient. A 41-year-old woman was admitted to our hospital because of hyperglycemia and dysuria. She had stopped insulin self-injection therapy for 2 years and diarrhea had become worse, resulting in malnutrition. Following enteral alimentation by elemental diet (ED) with continuous subcutaneous insulin infusion (CSII), frequency of diarrhea remarkably decreased and general nutritional condition was improved. At the first step, the patient was given 600 kcal/d ED through the tube sustained in the jejunum. Total calorie intake for 24 hours was gradually increased to the level of 2400 kcal/d and this therapy continued for 5 months. During this period, blood glucose level was kept in almost normal range (between 100 and 200 mg/dL) through the continuous insulin infusion of regular insulin (1.0-1.5 U/h). Thereafter, general conditions were improved and frequency of diarrhea gradually decreased. When this treatment was stopped, watery diarrhea, steatorrhea, and hypoalbuminemia completely disappeared and she gained 12 kg of body weight. Furthermore, spontaneous urination appeared following this treatment. This case suggests that the enteral hyperalimentation combined with strict control of blood glucose, using the CSII, may be an effective therapy for such severe diarrhea with malnutrition in diabetes.- - - - - - - - - - ranking = 2keywords = malnutrition (Clic here for more details about this article) |
7/19. Resolution of cryptosporidium infection in an AIDS patient after improvement of nutritional and immune status with octreotide.An AIDS patient with severe large volume diarrhea and malnutrition due to cryptosporidial infection is presented. The patient, who was not receiving zidovudine, was treated with octreotide with resolution of diarrhea leading to improvement in nutritional status, immune functions, and subsequently, resolution of the cryptosporidium infection. This case points out the need for adequate nutrition in AIDS patients and highlights the relationship of nutrition and the immune system.- - - - - - - - - - ranking = 1keywords = malnutrition (Clic here for more details about this article) |
8/19. Weanling diarrhea: a case report.This case report describes a 14-month-old Guatemalan boy suffering from diarrhea and malnutrition. He had been healthy and experienced normal growth until weaning, which began at six months of age. Introduction of semisolid foods at this time was accompanied by bouts of diarrhea and a reduced growth rate. After admission to hospital at 14 months of age, he was found to have protein-energy malnutrition of the edematous type (kwashiorkor) and to be infected with giardia lamblia. Therapy with metronidazole and a high-protein diet resulted in satisfactory weight gain and cessation of the diarrhea.- - - - - - - - - - ranking = 2keywords = malnutrition (Clic here for more details about this article) |
9/19. Nutrition support of intractable diarrhea. A case report and literature review.Intractable diarrhea is an important cause of severe malnutrition and growth failure during infancy. Early recognition and intervention under the direction of the nutritional support team facilitates successful recovery from the disease.- - - - - - - - - - ranking = 1keywords = malnutrition (Clic here for more details about this article) |
10/19. Severe gastrointestinal involvement in children with the acquired immunodeficiency syndrome.Five children with the acquired immunodeficiency syndrome (AIDS) and unusual gastrointestinal disease are described. Two children presented with malnutrition, abdominal distention, and diarrhea. One was found to have moderately severe villus atrophy on jejunal biopsy and was initially thought to have celiac disease. Jejunal biopsy from the second child revealed infiltration of the mucosa with acid-fast bacilli-laden macrophages. A third child suffered recurrent abdominal pain, progressive weight loss, diarrhea, and severe gastrointestinal hemorrhage secondary to infection with cytomegalovirus. Pseudomembranous necrotizing jejunitis associated with overgrowth of klebsiella pneumoniae in the duodenal fluid occurred in one patient. The fifth child presented in the newborn period with serratia marcescens cholecystitis. Gastrointestinal disease in children with AIDS may be due to idiopathic villus atrophy and bacterial or opportunistic infection.- - - - - - - - - - ranking = 1keywords = malnutrition (Clic here for more details about this article) |
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