Postoperative Malabsorption Secondary Protein Malnutrition Syndrome

Leitner, Z. A.

doi:10.1016/s0140-6736(58)91288-1

Cited by 13 publications

(3 citation statements)

References 6 publications

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“…The cause of the atrophy of the pancreas is not known, but it may be the result of chronic malnutrition, especially of protein as occurs in kwashiorkor, or it may be due to lack of stimulation of the pancreas by secretin (Jackson, Linder, and Berman, 1951 ;Dreiling, 1957;Leitner, 1958 Traditionally the steatorrhoea in this group has been attributed to blockage of lymphatics, but involvement of the mucosa is probably more important because, even 'in Hodgkin's disease and other lymphomatous conditions of the mesentery, not only fat but also sugar is poorly absorbed (French, 1955). In Crohn's disease and other chronic granulomata the ill effects of the underlying disease are often increased by those of resection of the gut and the formation of blind loops of bowel.…”

mentioning

confidence: 99%

Steatorrhoea in the Adult

Badenoch¹

1960

BMJ

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mentioning

confidence: 99%

Steatorrhoea in the Adult

Badenoch¹

1960

BMJ

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“…They were elderly subjects with low body weight and, although speculative, with possible limited liver glycogen stores. In such a case, we have to consider Kwashiorkor-type malnutrition ( 6 , 7 ). It is known that Kwashiorkor-type malnutrition also causes fatty liver and/or liver dysfunction same as anorexia nervosa.…”

Section: Discussionmentioning

confidence: 99%

Hypoinsulinemic hypoglycemia triggered by liver injury in elderly subjects with low body weight: case reports

Anno

Kaneto

Shigemoto

et al. 2018

Endocrinology, Diabetes &Amp; Metabolism Case Reports

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SummaryHypoglycemia is induced by many causes, especially over-dose of insulin or oral hypoglycemic agents in diabetic subjects. In such a case, hyperinsulinemic hypoglycemia is usually observed. On the other hand, it is important to classify secondary hypoglycemia and hypoinsulinemic hypoglycemia. Liver injury-induced hypoglycemia is one of the causes of hypoinsulinemic hypoglycemia but rarely observed in clinical practice. Herein, we experienced similar 2 cases of non-diabetic hypoinsulinemic hypoglycemia. Both of them were elderly subjects with low body weight. Furthermore, it is likely that hypoinsulinemic hypoglycemia in both subjects was triggered by severe liver injury, at least in part, due to possible limited liver glycogen store. In elderly subjects with low body weight and/or malnutrition, metabolism in the liver is reduced and glycogen accumulation is decreased. Such alteration brings out acute and marked liver injury, which finally leads to the onset of severe hypoglycemia. It is known that not only liver injury but also multiple organ failure could be induced due to extreme emaciation in subjects. It is likely that in elderly subjects with low body weight and/or malnutrition, multiple organ failure including liver failure could be induced due to the similar reason. Therefore, we should be very careful of such subjects in order to avoid the development of multiple organ failure which leads to life-threatening situations. In conclusion, we should keep in mind the possibility of hypoinsulinemic hypoglycemia when we examine severe liver injury, especially in elderly or starving subjects with low body weight and limited liver glycogen stores.Learning points:It is important to classify secondary hypoglycemia and hypoinsulinemic hypoglycemia.Liver injury-induced hypoglycemia is one of the causes of hypoinsulinemic hypoglycemia but rarely observed in everyday clinical practice.Herein, we reported similar 2 cases of hypoinsulinemic hypoglycemia without diabetes presumably triggered by severe liver injury.In both cases, hypoglycemia was improved by glucose infusion, although their liver injury was not improved.We should keep in mind the possibility of hypoinsulinemic hypoglycemia when we examine severe liver injury, especially in elderly subjects with low body weight.

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“…2). Malabsorption has been recognized as a cause of the kwashiorkor syndrome on only rare occasions (Krikler & Schrire, 1958;Leitner, 1958;Silverblatt & Brown, 1960;Brain, Anstall & Jeejeebhoy, 1965;Neale et al, 1967). There are, however, many descriptions by earlier workers of severe malnutrition of a similar kind in infants with gastroenteritis fed solely on a cereal diet for several weeks (Czerny & Keller, 1906) and in patients with malabsorption following gastro-intestinal surgery (e.g.…”

Section: Protein Calorie Malnutrition Resembling Kwashiorkormentioning

confidence: 99%

Protein malnutrition in gastro-intestinal disease

Neale¹

1968

Postgraduate Medical Journal

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Postoperative Malabsorption Secondary Protein Malnutrition Syndrome

Cited by 13 publications

References 6 publications

Steatorrhoea in the Adult

Steatorrhoea in the Adult

Hypoinsulinemic hypoglycemia triggered by liver injury in elderly subjects with low body weight: case reports

Protein malnutrition in gastro-intestinal disease

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