Assuntos
Giardíase/complicações , Jejuno/patologia , Atrofia , Criança , Pré-Escolar , Doença Crônica , Diarreia/etiologia , Humanos , LactenteRESUMO
Two hundred children hospitalized in the National Institute of Gastroenterology were studied during the 1972-1980 period. The children, whose ages ranged between six months and ten years, presented chronic diarrhea in which Giardia lamblia was considered the causative agent. The diagnosis of parasitism was made with the detection of Giardia lamblia in the feces and/or duodenal content. A serum D-Xylose and jejunal biopsy were performed on all the patients and the histology of the mucosa was classified in keeping with the degree of atrophy according to Metayer and Laumonier. In our study we divided the patients into three groups: Group 1, parasitism due to Giardia lamblia in patients with a normal D-xylose and different degrees of atrophy of the jejunal mucosa, but with normal D-Xylose and Group 3, malabsorption due to Giardia lamblia, with a pathological D-Xylose and alterations in the intestinal mucosa. There were 35 cases in Group 1 (17.5%), 91 cases in Group 2 (45.5%) and 74 cases in Group 3 (37%). The predominant intestinal lesion was partial atrophy of the villi (143), 20 with subtotal atrophy of the villi and two with complete atrophy of the villi. It was shown that the host's response to infection by Giardia lamblia varies with differing effects on the structures and functioning of the jejunal mucosa. It is important to group patients with chronic diarrhea due to Giardia lamblia in this way since it allows for and individualized clinical approach and provides a prognosis in terms nutritional consequences resulting from possible persistence of the diarrhea and possible associated lactose intolerance.
Assuntos
Diarreia/etiologia , Giardíase/complicações , Mucosa Intestinal/patologia , Jejuno/patologia , Criança , Pré-Escolar , Giardíase/diagnóstico , Humanos , Lactente , Absorção Intestinal , XiloseRESUMO
Two hundred children hospitalized in the National Institute of Gastroenterology were studied during the 1972-1980 period. The children, whose ages ranged between six months and ten years, presented chronic diarrhea in which Giardia lamblia was considered the causative agent. The diagnosis of parasitism was made with the detection of Giardia lamblia in the feces and/or duodenal content. A serum D-Xylose and jejunal biopsy were performed on all the patients and the histology of the mucosa was classified in keeping with the degree of atrophy according to Metayer and Laumonier. In our study we divided the patients into three groups: Group 1, parasitism due to Giardia lamblia in patients with a normal D-xylose and different degrees of atrophy of the jejunal mucosa, but with normal D-Xylose and Group 3, malabsorption due to Giardia lamblia, with a pathological D-Xylose and alterations in the intestinal mucosa. There were 35 cases in Group 1 (17.5
), 91 cases in Group 2 (45.5
) and 74 cases in Group 3 (37
). The predominant intestinal lesion was partial atrophy of the villi (143), 20 with subtotal atrophy of the villi and two with complete atrophy of the villi. It was shown that the hosts response to infection by Giardia lamblia varies with differing effects on the structures and functioning of the jejunal mucosa. It is important to group patients with chronic diarrhea due to Giardia lamblia in this way since it allows for and individualized clinical approach and provides a prognosis in terms nutritional consequences resulting from possible persistence of the diarrhea and possible associated lactose intolerance.
RESUMO
Results of the diagnosis, evolution and treatment of a study performed during the last 6 years in 50 children, carriers of chronic hepatitis are reported; they were patients of the Pediatric service at the Institute of Gastroenterology, corresponding, 25 to the persistent variety, and the rest to the active. Diagnosis was made by clinical, biochemical, laparoscopic and hepatic histological aspects. The importance of diagnostic laparoscopy and its correlation with hepatic biopsy are indicated. The highest incidence corresponded to patients between 4 and 6 years and 10 and 11 years of age, with a predominance of females. In the persistent variety, normality was achieved with bedrest without the need of medicines. In the active variety, the treatment used was prednisone or its combination with azathioprine, when an adequate response was not obtained or initially in severe cases, obtaining normality in 20% of them with a histological picture of persistent in 16% of the cases and the disease being maintained in 64%, with variations from a degree of inactivity to a now satisfactory picture with a progressive evolution to hepatic cirrhosis. There is no mortality reported in the casuistics.
Assuntos
Hepatite/diagnóstico , Adolescente , Criança , Pré-Escolar , Doença Crônica , Hepatite/patologia , Hepatite/terapia , Humanos , Lactente , Laparoscopia , Fígado/patologiaRESUMO
A study performed in 50 children carriers of celiac disease with ages between 8 months and 14 years of age, is presented; diagnosis was proved based on clinical picture, histological changes of jejunal mucosa, intestinal absorption tests and response to the suppression of gluten from the diet, with clinical, histological and biochemical control according to international criteria. It has been insisted on the familial study and the gluten overload test and its incidency in the black race. The development of public health has made it possible to demostrate the existence of this disease in our country.