Резюме
Определение
Анамнез и осмотр
Ключевые диагностические факторы
- exposição prolongada a uma área endêmica
- sintomas constitucionais
- diarreia
- distensão abdominal
- fezes gordurosas e fétidas
- glossite
- dormência dos dedos das mãos e dos pés
Другие диагностические факторы
- cólica abdominal
- febre
- edema dos membros inferiores
- queda de cabelos
- queilite/estomatite angular
- edema nos pés
- ruídos hidroaéreos hiperativos/borborigmos
- hiperpigmentação/erupção eczematosa
- palidez
- olhos secos
- xerose da córnea
- cegueira noturna
- diminuição de reflexos tendinosos profundos/diminuição de sensibilidade vibratória
Факторы риска
- exposição prolongada a uma área endêmica
- antígeno leucocitário humano (HLA) nas séries Aw-19
Диагностические исследования
Исследования, которые показаны в первую очередь
- Hemograma completo
- ensaio quantitativo de gordura fecal
- teste D-xilose
- folato sérico
- vitamina B12 sérica
Исследования, проведение которых нужно рассмотреть
- pesquisa de ovos e parasitas nas fezes
- coprocultura
- endoscopia digestiva alta com biópsia
- tentativa terapêutica com ácido fólico
Алгоритм лечения
sintomas de espru tropical
Составители
Авторы
Daniel Wild, MD
Professor of Medicine
Division of Gastroenterology
Duke University Medical Center
Durham
NC
Раскрытие информации
DW declares that he has no competing interests.
Iris L. Vance, MD
Assistant Professor of Medicine
Division of Gastroenterology
Duke University Medical Center
Durham
NC
Раскрытие информации
ILV declares that she has no competing interests.
Выражение благодарностей
Dr Daniel Wild and Dr Iris L. Vance would like to gratefully acknowledge Dr Moises Guelrud, a previous contributor to this topic. MG declares that he has no competing interests.
Рецензенты
J. Thomas LaMont, MD
Professor of Medicine
Harvard Medical School
Division of Gastroenterology
Beth Israel Deaconess Medical Center
Boston
MA
Раскрытие информации
JTLM declares that he has no competing interests.
Daniel Leffler, MD, MS
Instructor in Medicine
Harvard Medical School
Director of Clinical Research
The Celiac Center
Beth Israel Deaconess Medical Center
Boston
MA
Disclosures
DL declares that he has no competing interests.
Paul Ciclitira, MBBS, MD, PhD
Professor of Gastroenterology
Department of Diabetes and Nutritional Sciences
King's College London
Rayne Institute
St Thomas' Hospital
London
UK
Disclosures
PC declares that he has no competing interests.
References
Key articles
Keele KD, Bound JP. Sprue in India: a clinical survey of 600 cases. BMJ. 1946;1:77-81.
Sheehy TW, Cohen WC, Wallace DK, et al. Tropical sprue in North Americans. JAMA. 1965;194:1069-1076. Abstract
Sheehy TW, Baggs B, Perez-Santiago E, et al. Prognosis of tropical sprue. A study of the effect of folic acid on the intestinal aspects of acute and chronic sprue. Ann Intern Med. 1962;57:892-908. Abstract
Suarez RM, Spies TD, Suarez RM Jr. The use of folic acid in sprue. Ann Intern Med. 1947;26:642-677.
Rickles FR, Klipstein FA, Tomasini J, et al. Long-term follow-up of antibiotic-treated tropical sprue. Ann Intern Med. 1972;76:203-210. Abstract
Guerra R, Wheby MS, Bayless TM. Long term antibiotic in tropical sprue. Ann Intern Med. 1965;63:619-634. Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Infecções parasitárias: Strongyloides, Isosporiasis, Giardia lambia, Entamoeba histolytica, Ciclosporíase
- Infecções bacterianas: Shigella, Salmonella, Escherichia coli
- Enteropatia por vírus da imunodeficiência humana (HIV)
More DifferentialsGuidelines
- American Society for Gastrointestinal Endoscopy guideline on informed consent for GI endoscopic procedures
More Guidelines
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