RESUMEN
Ten samples of jejunal fluid from patients with tropical sprue and 11 from controls without this disease were examined bacteriologically, using techniques designed to obtain the optimal yield of aerobic and anaerobic bacteria. Total colony counts did not differ significantly in the two groups studied. The organisms isolated comprised a wide range of aerobic and anaerobic bacteria. With the exception of Haemophilus species, no bacterial group was isolated in significantly greater numbers in sprue patients than in controls. The pathogenesis of tropical sprue in Natal is discussed in the light of these findings.
Asunto(s)
Bacterias/aislamiento & purificación , Yeyuno/microbiología , Esprue Tropical/microbiología , HumanosRESUMEN
Ninety-five patients who had megaloblastic anaemia, and who lived in a subtropical climate, were studied to elucidate the importance of puerperium, malabsorption, gastric dystrophy, diet and infection in the aetiology of the disease. All 5 factors were found to be common, and to occur in a variety of combinations, producing a wide spectrum of illness variously resembling nutritional megaloblastic anaemia, sprue, pernicious anaemia and many stages in between. It is concluded that megaloblastic anaemia in this population is a multifactorial disease, and a tentative scheme, relating the aetiological factors, is drawn up. Neither serum vitamin B(12) levels, nor folate estimation in serum or red cells emerged as very reliable guides to the underlying biochemical deficiency.
Asunto(s)
Anemia Macrocítica/etiología , Anemia Megaloblástica/etiología , Adolescente , Adulto , Anemia Megaloblástica/sangre , Anemia Megaloblástica/tratamiento farmacológico , Ensayos Clínicos como Asunto , Método Doble Ciego , Femenino , Ácido Fólico/sangre , Ácido Fólico/uso terapéutico , Humanos , Infecciones/complicaciones , Síndromes de Malabsorción/complicaciones , Masculino , Tetraciclina/uso terapéutico , Vitamina B 12/sangreRESUMEN
Cell-mediated immunity has been studied in patients with 1) megaloblastic anemia of folic acid deficiency, 2)megaloblastic anemia of pregnancy, or 3) iron-deficiency anemia. Using dinitrochlorobenzene skin tests, phytohemagglutinin-stimulated lymphocyte transformation, and rosette inhibition by antilymphocyte globulin, we have shown that cell-mediated immunity is depressed in megaloblastic anemia due to folate deficiency; this depression was reversed by folate treatment. Cell-mediated immunity was not impaired by iron-deficiency anemia. Suggested interactions between iron deficiency and folate metabolism were not clarified by these studies.
Asunto(s)
Anemia Hipocrómica/inmunología , Anemia Macrocítica/inmunología , Anemia Megaloblástica/inmunología , Deficiencia de Ácido Fólico/complicaciones , Inmunidad Celular , Complicaciones Hematológicas del Embarazo , Adolescente , Adulto , África Austral , Anemia Megaloblástica/tratamiento farmacológico , Niño , Femenino , Ácido Fólico/uso terapéutico , Humanos , Reacción de Inmunoadherencia , Lectinas/farmacología , Activación de Linfocitos/efectos de los fármacos , Persona de Mediana Edad , Embarazo , Pruebas CutáneasRESUMEN
Twenty-four patients have been found who appear to have endemic tropical sprue, with malabsorption on biochemical, radiological and histological grounds. Patients with the tropical sprue syndrome responded equally well clinically and biochemically to folate and tetracycline. Jejunal histology responded least well to treatment. It is suggested that as more Gastrointestinal Units are opened, especially in humid sea level areas in Africa, more cases of endemic tropical sprue will be found.