Tropical Sprue—An Iceberg Disease?

Excerpt

The presence of overt tropical sprue in endemic, and occasionally epidemic, form has been recognized in certain islands of the Caribbean, the Indian subcontinent, and Southeast Asia for more than 2 centuries. Patients with the overt form of this disease usually present with gastrointestinal symptoms and weight loss and are found to have villose atrophy and malabsorption. Impaired intestinal absorption results in the development of multiple deficiencies that become clinically manifest with progression of the disease.

The increasingly widespread use of peroral jejunal biopsy for the evaluation of intestinal disorders during the past several years has made evident that the