Skip to content

Patient case: Tropical Sprue

Discussion

A 42-year-old man presents with a 6-month history of persistent diarrhea, weight loss, and generalized weakness. He reports that his symptoms began after traveling to a tropical region for a work assignment. Initially, he experienced intermittent episodes of diarrhea, but over time, the frequency increased to several times a day, accompanied by abdominal cramps and bloating. He also notes fatigue and difficulty concentrating. On examination, he appears pale and malnourished. Laboratory tests reveal macrocytic anemia, low serum folate, and vitamin B12 deficiency. Stool tests are negative for infectious causes, and a small bowel biopsy shows villous atrophy, suggestive of tropical sprue. The patient is started on antibiotics and nutritional supplementation, including folic acid and vitamin B12. He experiences gradual improvement in symptoms over the following weeks.

 

Questions
1. What is the most common symptom of Tropical Sprue?

a) Weight gain

b) Diarrhea

c) Vomiting

d) Constipation

2. Which deficiencies are typically found in patients with Tropical Sprue?

a) Vitamin C and calcium

b) Iron and potassium

c) Folate and vitamin B12

d) Vitamin D and magnesium

3. What is the most important diagnostic finding in a small bowel biopsy for Tropical Sprue?

a) Villous atrophy

b) Increased goblet cells

c) Crypt hyperplasia

d) Thickened mucosa

4. What is the main treatment approach for Tropical Sprue?

a) Surgical resection

b) Antacids and dietary restrictions

c) Antibiotics and nutritional supplements

d) Chemotherapy and radiation

Reveal answers

Answers

1 b) Diarrhea

2 c) Folate and vitamin B12

3 a) Villous atrophy

4 c) Antibiotics and nutritional supplements

Are you a Medical Doctor?