Folic acid malabsorption in cardiac failure.

Hyde, R. D.; Loehry, C A

doi:10.1136/gut.9.6.717

Cited by 13 publications

(7 citation statements)

References 16 publications

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“…It perhaps most resembles the reversible steatorrhoea found in 33 % of patients with ulcerative colitis, though in this instance the authors (Salem and Truelove, 1965) were not able to exclude direct involvement of the small bowel by the primary disease. The malabsorption of folate found in patients with heart failure (Hyde and Loehry, 1968) may be comparable too. With these possible exceptions dermatogenic enteropathy would appear to be unique in the frequency of its occurrence but systematic studies in large numbers of patients with other chronic disease may show that this is not so.…”

Section: Discussionmentioning

confidence: 80%

Dermatogenic enteropathy

Marks¹,

Shuster²

1970

Gut

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SUMMARY Steatorrhoea has been found in a large proportion of patients with inflammatory dermatoses, especially eczema and psoriasis. It is due to the rash itself and disappears rapidly after topical treatment of the skin. This particular enteropathy, unlike that associated with dermatitis herpetiformis, is not accompanied by an alteration in the stereomicroscopic appearance of the small bowel mucosa. The mechanism is not known. It is important to differentiate dermatogenic enteropathy from gluten sensitivity which has produced a rash, as in the former condition a gluten-free diet is not indicated.Dermatogenic enteropathy is an entity which is best understood in the context of the four known associations between skin and gut abnormalities (Shuster, 1967a and b;Shuster and Marks, 1970). These are: when malabsorption causes a rash, as in tropical sprue and 'idiopathic' steatorrhoea (group I); when skin disease causes malabsorption (dermatogenic enteropathy (group II); when skin and gut lesions are both due to the same pathological process as in the collagenoses (group III); and (group IV) when skin and gut lesions are indirectly related, as in dermatitis herpetiformis, which is associated with the coeliac syndrome more often than would be expected by chance but not in any of the three previous instances.It can be seen that dermatogenic enteropathy differs fundamentally from other forms of malabsorption associated with skin disease in that it is caused by the rash itself, and some of the evidence for this has been presented and discussed already Shuster, 1967a and b;Marks, 1968;Shuster, 1968a and b;Marks, Shuster, and Watson, 1970;Shuster and Marks, 1970). As new information has become available it has supported the authors' original hypothesis and only in one respect is there an apparent conflict between the present paper and a previous report (Shuster, Watson, and Marks, 1967b). The present authors no longer believe that there is evidence of a structural mucosal abnormality in dermatogenic enteropathy. This paper will be concerned mainly with malabsorption of fat, although there is evidence of malabsorption of D-xylose (Marks, 1968;Shuster and Marks, 1970) and iron (Marks and Shuster, 1968) and perhaps folate (Kaimis, Summerly, and Giles, personal communication, 1969) and vitamin B12 in some patients with dermatogenic enteropathy.The interpretation of results of many 'absorption' tests in patients with skin disease is notoriously difficult (Knowles, Shuster, and Wells, 1963;Fry, Shuster, and McMinn, 1965;Doran, Everett, and Welsh, 1966; Shuster, 1967a and b;Marks and Shuster, 1968;Shuster and Marks, 1970) and will be discussed only briefly.

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Section: Discussionmentioning

confidence: 80%

Dermatogenic enteropathy

Marks¹,

Shuster²

1970

Gut

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“…Although folate deficiency in tropical sprue has long been attributed to malabsorption, the latter could not be consistently demonstrated with physiologic doses until independent studies demonstrated that malabsorption of these doses was only detectable in the presence of glucose or galactose (Gerson et al, 1974;Corcino et al, 1975Corcino et al, , 1976. The extensive list of gastrointestinal and systemic diseases previously known to be associated with folate malabsorption has been enlarged by evidence that this may occur in cardiac failure (Hyde and Loehry, 1968), dermatitis herpetiformis , and systemic bacterial infections (Cook et al, 1974). Alcohol appears to impair absorption of the vitamin only when it is superimposed on a poor diet (Halsted et al, 1971(Halsted et al, , 1973.…”

Section: Mucosal Transportmentioning

confidence: 97%

Folate Deficiency in Humans

Colman

1977

Advances in Nutritional Research

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“…Hyde and Loehry (1968) reported malabsorption of pteroylglutamic acid in seven of 25 patients tested, malabsorption being most frequent in those with long-standing heart failure. Lymphosarcoma and chronic lymphocytic leukaemia Pitney, Joske, and MacKinnon (1960) found reduced absorption of pteroylglutamic acid in eight of 10 patients with a lymphoma and five of eight with chronic lymphocytic leukaemia.…”

Section: Folate Deficiencymentioning

confidence: 97%

“…Congestive heart failure This is a recently recognized cause of folate deficiency (Hyde and Loehry, 1968;Brody, Soltys, and Zinsser, 1969) and the major factor is probably excess urinary folate excretion (Retief and Huskisson, 1969). Hyde and Loehry (1968) reported malabsorption of pteroylglutamic acid in seven of 25 patients tested, malabsorption being most frequent in those with long-standing heart failure.…”

Section: Folate Deficiencymentioning

confidence: 99%

Folate absorption

Hoffbrand¹

1971

Journal of Clinical Pathology

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Folic acid malabsorption in cardiac failure.

Cited by 13 publications

References 16 publications

Dermatogenic enteropathy

Dermatogenic enteropathy

Folate Deficiency in Humans

Folate absorption

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