Histologic diagnosis of diseases of malabsorption

  • Lloyd L. Brandborg
    Requests for reprints should he addressed to Dr. Lloyd L. Brandborg, Veterans Administration Medical Center, San Francisco, 4150 Clement Street, San Francisco, California 94121.
    San Francisco, California USA
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  • Author Footnotes
    1 From the Department of Medicine, University of California, San Francisco, San Francisco, California 94121.
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      The diagnoses which may be arrived at by examination of peroral small bowel mucosal biopsy specimens are presented. Celiac sprue, unclassified sprue (refractory sprue), infectious gastroenterititis, stasis syndrome and kwashiorkor have a severe mucosal lesion. Other clinical conditions are required to establish the diagnosis in these diseases. A number of diseases have specific diagnostic features. Included are Whipple's disease, abetalipoproteinemia, collagenous sprue, primary intestinal lymphoma, esosinophilic gastroenteritis, giardiasis, coccidiosis, strongyloidiasis, lymphangiectasis and the intestinal immunodeficiency diseases. Mucosal abnormalities may be present in other diseases but the diagnoses are usually made on other criteria than small bowel biopsy. These include vitamin B12 or folic acid deficiency, Crohn's disease, gastrinoma, acrodermatitis ehteropathica, amyloidpsis, chronic granulomatous disease, lipid storage diseases, histoplasmosis, capillariasis, cytomegalovirus infection, schistosomiasis and macroglobulinemia.
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