Tropical Sprue

• A.k.a. “Post-infective tropical malabsorption”
• Malabsorption associated with villous atrophy
• In the absence of anti-gliadin pathophysiology
• Incidence
  • Most commonly from travel to SE Asia
• Aetiology
  • ? Infective
• Clinical
  • Diarrhoea
  • Usually (low folate) anaemia
  • ± Low albumin
• Pathology
  • Subtotal villous atrophy
• Ix
  • Tests of malabsorption
  • Jejunal Bx: Increased villous atrophy & characteristic accumulation of lipid beneath basement membrane
• Mx
  • Tetracycline 250mg qid + Folic acid for 1/12
  • Correction of fluid / nutritional deficiency
• Prognosis / Natural Hx:
  • Usually resolves over approximately one month