Chronic malabsorption due to cryptosporidiosis in a child with immunoglobulin deficiency

Sloper, K S; Dourmashkin, R. R.; Bird, R B; Slavin, G; Webster, A. D. B.

doi:10.1136/gut.23.1.80

Cited by 111 publications

(35 citation statements)

References 6 publications

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“…One child had chronic diarrhoea that lasted for four years and remained unresolved,2 and a second child, who also had hypogammaglobulinaemia with raised IgM concentrations, died after protracted diarrhoea lasting six years. 2 After our patient was treated with hyperimmune bovine colostrum faeces were found to be free of oocysts and diarrhoea stopped. The major secretary immunoglobulin in the cow is IgGl, which fulfils the same role in ruminants as IgA does in monogastric species by being resistant to low pH and luminal proteolysis.6 Colostrum is therefore more likely to be effective when administered orally than is purified bovine serum IgG.…”

Section: Discussionmentioning

confidence: 79%

Remission of diarrhoea due to cryptosporidiosis in an immunodeficient child treated with hyperimmune bovine colostrum.

Tzipori¹,

Roberton²,

Chapman³

1986

BMJ

170

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A boy aged 6 months who presented with poor weight gain, diarrhoea, and infection with Pneumocystis carinii was found to have congenital hypogammaglobulinaemia, which did not improve despite monthly treatment with intravenous gammaglobulin. At the age of 3 years and 2 months he developed severe vomiting and diarrhoea due to cryptosporidiosis, which failed to respond to conventional treatment. Infusion of hyperimmune bovine colostrum produced against parasite antigen, given by nasogastric tube, was started after symptoms had persisted for three weeks. His vomiting and diarrhoea resolved within five days of treatment, and oocysts were no longer seen in the stools after eight days. Later, however, he developed a rare complication, and oocysts were found in the common bile duct.Hyperimmune bovine colostrum may be useful in the treatment of many patients with immunodeficiency disorders.

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Section: Discussionmentioning

confidence: 79%

Remission of diarrhoea due to cryptosporidiosis in an immunodeficient child treated with hyperimmune bovine colostrum.

Tzipori¹,

Roberton²,

Chapman³

1986

BMJ

170

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“…In the most severely immunocompromised host, such as persons with AIDS, diarrheal illness due to Cryptosporidium infection of the gastrointestinal tract becomes progressively worse with time and may be a major factor leading to death. It is believed that the infection usually begins with organisms colonizing the ileum orjejunum and develops into a life-threatening condition when a large portion of the gastrointestinal mucosa is covered with parasites (40,288). Fluid loss in patients with AIDS and cryptosporidiosis is often excessive; 3 to 6 liters of diarrheic stool per day is common, and as much as 17 liters of watery stool per day has been reported (55).…”

Section: Downloaded Frommentioning

confidence: 99%

Cryptosporidiosis

1991

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Before 1982, only eight case reports of human cryptosporidiosis and fewer than 30 papers on Cryptosporidium spp. appeared in the biomedical literature. At that time, cryptosporidiosis was thought to be an infrequent infection in animals and rarely an opportunistic infection in humans. The concept of Cryptosporidium spp. as pathogens has changed dramatically within the past 8 years because of improved diagnostic techniques, increased awareness within the biomedical community, and the development of basic research programs in numerous laboratories. Presently, greater than 1,000 publications including over 400 case reports in the biomedical literature address Cryptosporidium spp. and cryptosporidiosis. Cryptosporidium parvum is now thought to be one of the three most common enteropathogens causing diarrheal illness in humans worldwide, especially in developing countries. It is likely that cryptosporidiosis was previously included in the 25 to 35% of diarrheal illness with unknown etiology. Because of the severity and length of diarrheal illness and because no effective therapy has been identified, cryptosporidiosis is one of the most ominous infections associated with AIDS. The role of C. parvum as an enteropathogen is well established; documentation of its role as a cause of hepatobiliary and respiratory diseases is now appearing in the literature. Our present understanding of the natural history, epidemiology, biology, and immunology of Cryptosporidium spp. as well as the clinical features, pathogenicity, and treatment of cryptosporidiosis are reviewed here.

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“…Diagnosis of the infection was effected by rectal biopsy. More recent publications (Slavin 1980, Bryceson 1980, Tzipori et al 1980b, Weinstein et al 1981,Sloper et al, 1982, Reese et al 1982 give well-documented accounts of 7 further cases in the United States and 4 in the UK. Of these patients, whose ages ranged from 3 to 58 years, 8 either were seriously immunodeficient or were receiving immunosuppressive treatment.…”

Section: Cryptosporidiosis In Manmentioning

confidence: 99%