Intestinal Biopsy in Kwashiorkor

Stanfield, J. P.; Hutt, M. S. R.; Tunnicliffe, R.

doi:10.1016/s0140-6736(65)91474-1

Cited by 204 publications

(71 citation statements)

References 18 publications

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“…Twenty patients (58.8%) presented moderate or severe morphological changes. The lesions were nonspecific in all cases and were similar to those reported for marasmus patients (8) and for children with kwashiorkor (12).…”

Section: Discussionsupporting

confidence: 85%

Morphological changes of the jejunal mucosa in protracted diarrhea and their correlation with disease duration, weight loss and serum albumin levels

La¹,

Fj³

1997

Braz J Med Biol Res

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The pathogenesis of protracted diarrhea is multifactorial. In developing countries, intestinal infectious processes seem to play an important role in triggering the syndrome. Thirty-four children aged 1 to 14 months, mean 6.5 months, with protracted diarrhea were studied clinically and in terms of small intestinal mucosal morphology. Mild, moderate or severe hypotrophy of the jejunal mucosa was detected in 82% of cases, and mucosal atrophy was observed in 12%. The intensity of the morphological changes of the jejunal mucosa correlated negatively with serum albumin levels. No correlation was detected between mucosal grading and duration of diarrhea or between mucosal grading and weight reported as percentile. After nutritional support was instituted, serial jejunal biopsies were obtained from 12 patients: five patients submitted to parenteral nutrition for 7 to 38 days, mean 17 days, and 7 patients receiving a hypoallergenic oral diet (semi-elemental formula, 3; chicken formula, 3; human milk, 1). In seven cases (58%) a progressive increase in villus height and a decrease in the number of inflammatory cells were noted. Recovery of the morphologic pattern was accompanied by clinical improvement in all patients.

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Section: Discussionsupporting

confidence: 85%

Morphological changes of the jejunal mucosa in protracted diarrhea and their correlation with disease duration, weight loss and serum albumin levels

La¹,

Fj³

1997

Braz J Med Biol Res

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“…This hormone inhibits the proximal gastric contraction and hence adds to the delayed GET in PEM (Lieverse et al, 1994). Also atrophy of the wall, musculature and the mucosa of the stomach in PEM (Stanfield et al, 1965) could be a contributing factor. The strength of antral contractions is one of the determinants of gastric emptying (Prove and Ehrlein, 1983), thus these pathological changes in PEM would ultimately lead to delayed GET.…”

Section: Discussionmentioning

confidence: 99%

Ultrasonographic gastric emptying in protein energy malnutrition: effect of type of meal and nutritional recovery

et al. 2004

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Objective and Design: The earlier reports of disturbed gastric motility in protein energy malnutrition (PEM) point out to its possible contribution in the difficulties faced during nutritional rehabilitation. This study was thus designed to assess the ultrasonographic gastric emptying time (GET) using 20 ml/kg body weight of both liquid and semisolid meals, in 27 patients suffering from PEM as well as in 15 healthy matching infants to delineate any defect present, its degree in different types of PEM and the effect of nutritional rehabilitation. Patients: The patients were recruited from the in-patient department of Children's Hospital, Ain Shams University, Cairo, Egypt. They were divided into three groups: 10 marasmic infants, 10 marasmic kwashiorkor (marasmic KWO) and seven kwashiorkor (KWO) cases. Ultrasonographic GET assessment was carried out within 72 h of admission and 3077 days after nutritional rehabilitation. Results: The gastric half-emptying time T(1/2) of both liquid and semisolid meals was markedly prolonged in patients with marasmus and marasmic KWO. It was more delayed for the semisolid than the liquid meals. This delay was reversible after nutritional rehabilitation of the patients, indicating that it was secondary to the malnourished status. On the other hand, T(1/2) of both liquid and semisolid meals showed no statistically significant delay in the KWO group and nutritional rehabilitation added no further to the results. Conclusion: PEM, especially marasmus and marasmic KWO, causes a delay in GET, which is reversible on nutritional recovery. This must be considered during nutritional rehabilitation of such patients to decrease the duration of their hospitalization and thus decrease the morbidity in PEM. Sponsorship: This study was supported by a university fund from

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“…[1][2][3][4][5] 18 Small segments (1-5-2-5 cm) of all killed animals were quickly obtained from proximal jejunum, just beyond the ligament of Treitz and from distal ileum, 2-3 cm proximal to the ileocaecal valve. These segments were placed serosal side down on a piece of cardboard, immersed in Bouin's fixative for 72 hours and embedded in paraffin; blocks were sectioned on the same microtome, at the same setting of 4 ,um and stained by haematoxylin and eosin for qualitative examination of the mucosa and by Periodic Acid-Schiff reaction for measurements.…”

Section: From Departments Of Pathology and Medicine (Nutrition Divisionmentioning

confidence: 99%

Morphometric study of the small intestinal mucosa in young, adult, and old rats submitted to protein deficiency and rehabilitation.

Rodrigues¹,

Camargo²,

Coelho³

et al. 1985

Gut

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SUMMARY Linear and stereological morphometric methods were applied to the jejunal and ileal mucosa of young, adult, and old male Wistar rats submitted to protein deficiency and rehabilitation. The animals were fed ad libitum a 2% casein diet during 42 days and then received a 20% casein diet for 30 days. Food intake, body weights, and plasma protein concentrations were recorded. In the young protein deficient rats values of mucosal height, surface area, and volume of the lamina propria were significantly lower than those of their age controls in both jejunum and ileum. In adults the differences were less marked and in the old rats all parameters were found to be unaltered by the protein deficient diet. The surface-to-volume ratio showed no significant differences between control and protein deficient in all three age groups, meaning that villus pattern did not change with protein deficiency. On rehabilitation, a striking difference between jejunum and ileum was observed in the young rats; all parameters returned to control levels in the jejunum, while they remained lower than those of their controls in the ileum.

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Intestinal Biopsy in Kwashiorkor

Cited by 204 publications

References 18 publications

Morphological changes of the jejunal mucosa in protracted diarrhea and their correlation with disease duration, weight loss and serum albumin levels

Morphological changes of the jejunal mucosa in protracted diarrhea and their correlation with disease duration, weight loss and serum albumin levels

Ultrasonographic gastric emptying in protein energy malnutrition: effect of type of meal and nutritional recovery

Morphometric study of the small intestinal mucosa in young, adult, and old rats submitted to protein deficiency and rehabilitation.

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