Tropical Sprue in Thailand

Report of the First Documented Case

Pipat JuttijudataDepartment of Medicine, Pra Mongkutklao Army General Hospital, Bangkok, Thailand

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Gerald T. KeuschDepartment of Medicine, Pra Mongkutklao Army General Hospital, Bangkok, Thailand

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Frank J. TroncaleDepartment of Medicine, Pra Mongkutklao Army General Hospital, Bangkok, Thailand

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Andrew G. PlautDepartment of Medicine, Pra Mongkutklao Army General Hospital, Bangkok, Thailand

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Richard D. BuchananDepartment of Medicine, Pra Mongkutklao Army General Hospital, Bangkok, Thailand

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Natth BhamarapravathiDepartment of Medicine, Pra Mongkutklao Army General Hospital, Bangkok, Thailand

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Abnormalities of the jejunal mucosa are commonly found in the Thai people, associated with a mild decrease in xylose excretion. Tropical sprue is reported to occur in India, Pakistan, Burma, Singapore, Vietnam, and Hong Kong, but has not been documented in Thailand. It has been suggested that tropical sprue is one extreme of a spectrum of abnormalities of the intestine found in tropical populations. To uncover cases of tropical sprue in Thailand, we sought and investigated patients with clinical disease suggestive of sprue. The diagnosis of tropical sprue was made in one patient, the subject of this report, on the basis of intestinal biopsy, function studies, and response to therapy. Tropical sprue therefore does occur in the Thai people, although it appears to be uncommon. Whether widespread use of broad-spectrum antibiotics by the general population or some other environmental condition limits the full manifestation of the disease, or whether tropical sprue is a specific disease that is not prevalent in Thailand is not known.

Author Notes

Associate, International Research Career Development Program, National Institutes of Health, Bethesda, Maryland 20014.

SEATO Medical Research Laboratory, Bangkok, Thailand.

Ramathibodi Hospital, Bangkok, Thailand.

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