Recent etiologies of Malabsorption syndrome among adults and features differentiating celiac disease and tropical malabsorption

ABSTRACT

Introduction: There is a constant change in the order of etiologies causing Malabsorption syndromes in India. Establishing the etiology of this challenging clinical disorder requires judicious use of a wide array of tests. Implementation of preventive health measures and improved sanitation may have changed the etiology of mal absorption syndrome. Aim: This study was aimed to document the recent etiologies of malabsorption syndromes and also to compare the features that differentiate tropical sprue from celiac disease, the recent two most common etiologies of mal absorption seen at our centre. Materials and methods: Patients seen at our centre with malabsorption syndromes from February 2016 to November 2018 were included in this study. The etiological, clinical and investigation details were recorded on uniform structured data forms. The data obtained was statistically analyzed. Results: Out of the 300 patients screened, 200 patients were included in the study; the other 100 patients were not included as they did not fit in to the inclusion criteria for malabsorption syndrome. Of these 200, 22 (11%) patients were in the age group between 13-19 years. Tropical malabsorption (n=82) was the common cause of MAS followed by celiac disease (n=42). 35 of 42 patients (83.3%) with celiac disease, who underwent test for anti-endomysial antibody, had positive result followed by giardiasis and other diseases. Of the remaining seven patients, four had low level of serum IgA, one had anti-tTG antibody and others had anti-gliadin antibody in serum. Two patients with strongyloidosis, Two patients with Chron’s and one patient with IPSID died. Frequency of recurrence Akula Sanjeevaiah, Akula Sushmitha, Thota Srikanth. Recent etiologies of Malabsorption syndrome among adults and features differentiating celiac disease and tropical malabsorption. IAIM, 2019; 6(3) 325-331. Page 326 after successful treatment was comparable among patients with celiac disease and tropical malaabsorption (two patients each) during a follow up period of 13.7 ± 16.1 and 14.7 ± 10.5 months, respectively. Conclusion: In the present study, tropical malabsorption and celiac disease were the most common causes of mal-absorption syndrome followed by giardiasis, AIDS and tuberculosis.