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Espru tropical

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  • Teoria
  • Diagnóstico
  • Tratamento
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Última revisão das evidências: 21 Feb 2026
Última atualização do tópico: 20 Apr 2023

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • exposição prolongada a uma área endêmica
  • sintomas constitucionais
  • diarreia
  • distensão abdominal
  • fezes gordurosas e fétidas
  • glossite
  • dormência dos dedos das mãos e dos pés
Detalhes completos

Outros fatores diagnósticos

  • 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
Detalhes completos

Fatores de risco

  • exposição prolongada a uma área endêmica
  • antígeno leucocitário humano (HLA) nas séries Aw-19
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • Hemograma completo
  • ensaio quantitativo de gordura fecal
  • teste D-xilose
  • folato sérico
  • vitamina B12 sérica
Detalhes completos

Investigações a serem consideradas

  • pesquisa de ovos e parasitas nas fezes
  • coprocultura
  • endoscopia digestiva alta com biópsia
  • tentativa terapêutica com ácido fólico
Detalhes completos

Algoritmo de tratamento

CONTÍNUA

sintomas de espru tropical

Colaboradores

Autores

Daniel Wild, MD

Professor of Medicine

Division of Gastroenterology

Duke University Medical Center

Durham

NC

Declarações

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

Declarações

ILV declares that she has no competing interests.

Agradecimentos

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.

Revisores

J. Thomas LaMont, MD

Professor of Medicine

Harvard Medical School

Division of Gastroenterology

Beth Israel Deaconess Medical Center

Boston

MA

Declarações

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.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

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.
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  • Guidelines

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