Malabsorption disorder

Vit A, D, E, K, B12, and Iron deficiency

A. Celiac disease: anemia, dermatitis herpitiformis Dx: antigliadin, antiendomysial, antitransgultaminase Ab, small bowel biopsy showing flattened villi


B. Chronic pancreatitis: Dx: xray, CT, secretin testing, low trypsin level
To differentiate A & B: 1. D-xylose test: B absorb, A doesn't 2. iron deficiency in A not in B

C. Tropical sprue: biopsy

D. Wipple: dementia, arthralgia, ophthalmopledia Dx: biopsy, PCR, foamy macrophage with PAS+

C & D have same treatment: sulfamethoxazole/trimethoprim or doxycycline for 6 mos. or ceftriaxone for 1 year