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Tropical Sprue—Specific Disease or Extreme of a Spectrum?

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University Hospital
The University of Michigan Medical Center
Ann Arbor, Mich.

Ann Intern Med. 1968;68(6):1362-1365. doi:10.7326/0003-4819-68-6-1362
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Tropical sprue is a form of malabsorption that occurs in residents of the tropics. Symptoms are those of malabsorption: diarrhea, abdominal distention, and weight loss with general malnutrition and specific nutritional deficiencies. Biopsies of small-intestinal mucosa show mild to moderate abnormality of villus architecture, changing from delicate fingerlike to leaflike, convoluted, or flattened villi. Intra-cytoplasmic vacuolation and disorganization of the brush border of epithelial cells are seen histologically, especially at the tips of villi. There are increases in lymphocytes, plasma cells, and sometimes eosinophils in the lamina propria of the villi. Severe abnormality, such as flattened epithelium completely lacking in


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