Antibiotic Therapy in Tropical Sprue
The Role of Dietary Folic Acid in the Hematologic Remission Associated with Oral Antibiotic Therapy
- FREDERICK A. KLIPSTEIN, M.D.
- Requests for reprints should be addressed to Frederick A. Klipstein, M.D., Francis Delafield Hospital, 99 Ft. Washington Ave., New York, N. Y. 10032.
Excerpt
The initial observations made 20 years ago that treatment with sulfonamide preparations arrested the diarrhea of military personnel in India afflicted with tropical sprue (1-3) have subsequently been confirmed and amplified. Anderson and co-workers (4) and French, Gaddie, and Smith (5) observed a gastrointestinal remission in all of seven British soldiers who had acquired tropical sprue in the Far East and were treated with broad spectrum antibiotics in Birmingham, England. Subsequently, studies of Puerto Rican patients, both in Puerto Rico (6, 7) and in New York City (8), and of Indian subjects in London (9, 10) have confirmed the fact
This 100-word excerpt has been provided in the absence of an abstract.
Acknowledgments
Drs. Patricia Campbell and Timothy Smelzer of the First Medical Division, Bellevue Hospital, gave permission to transfer this patient for study. Dr. J. Bertles gave permission to include data on the patient studied at the St. Lukes Hospital. Dr. Cedric W. Porter, Jr., assisted in care of the patient, Mrs. Ana Tiburcio performed the blood counts, Miss Edith McClung, R. N. and her staff of the Metabolic Unit assisted generally, Mrs. Patricia Weitzner helped perform the microbiological assays, and Mrs. Florence Lefcourt and Mrs. Beatrice Hatherley gave secretarial assistance.
Summario in Interlingua
Un patiente portorican con sprue tropic e anemia megaloblastic secundari a un combinate carentia de acido folic e vitamina B12 esseva tractate con antibioticos oral, con un dieta que contineva initialmente minus que 10 µg e subsequentemente 150 µg de activitate total de acido folic. Nulle responsa hematologic esseva observate usque le dieta continente le plus grande quantitate de acido folic esseva administrate. Quando le responsa se manifestava, illo consisteva in un augmento del concentration seral de folato e del excretion de 24 horas de acido folic in le urina verso valores normal, sed nulle alteration occurreva in le concentration seral de vitamina B12. Esseva trovate a ille tempore que le absorption jejunal esseva meliorate. Un subsequente therapia con 25 µg de libere acido folic esseva requirite pro effectuar un complete responsa hematologic. Sed mesmo iste therapia additional non resultava in un complete replenation del reservas de folato.
Le presente studio indica que un adequate provision dietari de acido folic es un precondition pro que le oral therapia antibiotic pote producer un remission hematologic del anemia megaloblastic que es essociate con sprue tropic. Illo suggere additionalmente que le mechanismo per le qual le oral therapia antibiotic produce iste remission age per meliorar le capacitate de absorption jejunal de maniera que sufficiente quantitates dietari de acido folic es absorbite.
Article and Author Information
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From the Department of Medicine, College of Physicians and Surgeons, Columbia University, and the Medical Service of the Francis Delafield Hospital, New York City, N. Y.
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This work was supported in part by grant CA-02332 from the United States Public Health Service, Bethesda, Md., and fellowship ACF 25b from the American Cancer Society.
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- Received April 9, 1964.
- Accepted May 29, 1964.
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