Adult hereditary fructose intolerance.

Hereditary fructose intolerance (HFI) is an under-recognized, preventable life-threatening condition. It is an autosomal recessive disorder with subnormal activity of aldolase B in the liver, kidney and small bowel. Symptoms are present only after the ingestion of fructose, which leads to brisk hypoglycemia, and an individual with continued ingestion will exhibit vomiting, abdominal pain, failure to thrive, and renal and liver failure. A diagnosis of HFI was made in a 50-year-old woman on the basis of medical history, response to IV fructose intolerance test, demonstration of aldolase B activity reduction in duodenal biopsy, and molecular analysis of leukocyte DNA by PCR showed homozygosity for two doses of mutant gene. HFI may remain undiagnosed until adult life and may lead to disastrous complications following inadvertent fructose or sorbitol infusion. Several lethal episodes of HFI following sorbitol and fructose infusion have been reported. The diagnosis can only be suspected by taking a careful dietary history, and this can present serious complications.

Does Helicobacter pylori infection in chronic renal failure increase the risk of gastroduodenal lesions? A prospective study.

BACKGROUND: Helicobacter pylori (H.pylori) plays an important role in gastroduodenal disease. However, there are few data concerning the epidemiology of H.pylori in patients with chronic renal failure and on hemodialysis (HD) treatment. AIM OF THE STUDY: This study is aimed to determine the epidemiology of H.pylori infection in patients with end stage renal disease (ESRD) on Hemodialysis (HD). PATIENTS AND METHODS: Ninety-six patients with dyspeptic complaints were included in the study. They were divided into two groups; group one consisted of 46 patients with ESRD on HD and group two (control) of 50 patients without renal disease. All patients were subjected to upper gastrointestinal endoscopies, and gastric biopsies were obtained for histological evidence of H. pylori infection. RESULTS: The mean age of both groups was similar. The prevalence of H.pylori among the two groups was not significantly different (45.7% Vs 48%=p > 0.05). The prevalence of duodenal ulcers was significantly higher in H.pylori positive than in H.pylori negative ESRD patients (p < 0.05). GERD was significantly lower in H.pylori positive patients in both groups (p < 0.001 and p < 0.01 respectively). CONCLUSION: This study showed a similar prevalence of H.pylori infection in both groups. H.pylori infection in patients with ESRD is probably associated with increased risk of gastroduodenal lesions.