Adult coeliac disease and other disorders associated with steatorrhoea

Aminoaciduria and megaloblastic anaemia

Urinary amino-acid chromatograms from 23 patients with megaloblastic anaemia have been studied before and after therapy. The most consistent abnormality was an increased taurine or increased taurine/glycine ratio. This was not related directly to deficiency of vitamin B(12) or folic acid or to the degree of anaemia.

ACUTE FOLIC ACID DEFICIENCY OF UNKNOWN AETIOLOGY: TEMPERATE SPRUE

The 20 patients described could be included in the group of patients diagnosed as ;idiopathic steatorrhoea'. However, their histories were short and diarrhoea was not a major feature. Since megaloblastic anaemia due to folic acid deficiency was a common feature it is suggested that these patients may form a homogeneous group and the diagnostic label of temperate sprue is suggested.

ADULT COELIAC DISEASE

A clinical, biochemical, and pathological study is recorded of 50 patients in whom a diagnosis of idiopathic steatorrhea had been made and who had ;flat' jejunal biopsies. It is suggested that there is an underlying constitutional defect, not yet clearly defined, and that possibly secondary intestinal infection allows the intestinal mucosa to become sensitized to substances in the diet. Of these gluten is the commonest; milk adversely affects others; and there may be other factors.

Intestinal reticulosis as a complication of idiopathic steatorrhoea

Three patients who had idiopathic steatorrhoea associated with reticulosarcoma of either the jejunum or the ileum are described. Previously reported cases with these features are reviewed and the suggestion is made that the reticulosis may arise as a complication of idiopathic steatorrhoea.

Co58B12 absorption (hepatic surface count) after gastrectomy, ileal resection, and in coeliac disorders

This paper demonstrates that the hepatic surface counting technique is a reliable and satisfactory method of estimating the absorption of radioactive vitamin B(12). It does not require the collection of faeces or urine and is therefore particularly useful in studying out-patients.