Tropical sprue is a rare disorder of unknown cause affecting people living in tropical and subtropical areas who develop abnormalities of the lining of the small intestine, leading to malabsorption and deficiencies of many nutrients.
The cause is unknown, but infection is suspected.
Typical symptoms include anemia, light-colored stools, chronic diarrhea, and weight loss.
A doctor bases the diagnosis on symptoms in a person who lives in or has recently visited one of the areas in which the disorder commonly occurs.
The antibiotic tetracycline treats the disorder.
Tropical sprue occurs chiefly in the Caribbean, southern India, and Southeast Asia. Both natives and visitors (who spend at least 1 month in the area) may develop the disease, but children are rarely affected. This disorder has rarely been reported in the United States. Worldwide, its occurrence has been declining in recent decades.
The cause of tropical sprue is unknown, but available evidence suggests an infectious cause.
Symptoms of Tropical Sprue
Typical symptoms of tropical sprue are light-colored, soft, bulky, greasy, and unusually foul-smelling stool (called steatorrhea), chronic diarrhea, fever, a general feeling of illness (malaise), and weight loss.
Other symptoms of malabsorption of specific nutrients may also develop. A sore tongue develops from vitamin B2 deficiency. Anemia usually develops as a result of iron deficiency, vitamin B12 deficiency, or , causing fatigue and weakness.
Diagnosis of Tropical Sprue
Biopsy
Blood tests
A doctor considers the diagnosis of tropical sprue in a person with anemia and symptoms of malabsorption who lives in or has recently visited one of the areas in which the disorder commonly occurs.
A doctor confirms the diagnosis by removing tissue (biopsy) from the small intestine using an endoscope (a flexible viewing tube equipped with a light source and a camera through which a small clipper can be inserted) and examining the tissue under a microscope. The doctor can identify some characteristic changes in the person's small intestine.
A stool sample is usually analyzed to exclude parasites or bacteria as a cause.
Blood tests are done to help determine whether people have undernutrition.
Treatment of Tropical Sprue
Tetracycline
Folate and vitamin B12 supplements
Treatment of tropical sprue usually results in a full recovery.
Nutritional supplements, especially folate and injections of vitamin B12, are given for several weeks. Other nutritional replacements are given as needed.
