HIV In Children
 
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Pedi Poll
Today's Poll
Should all patients with viral respiratory infection be treated with oseltamivir in current epidemic of H1N1 influenza_?
Yes, it may be H1N1
No, only if test is positive for influenza
Only in sick patients admitted in ICU
MALABSORPTION SYNDROMES
MALABSORPTION SYNDROMES
Dr. Saumil K. Shah
MD, DNB, DM, DNB
GASTROENTEROLOGIST, HEPATOLOGIST, ENDOSCOPIST
Honorary Consultant: Lilavati Hospital And Research Centre

Q. What are the causes of malabsorption in children?
A.

Deficiency or inactivation of pancreatic lipase
Inadequate digestion

  • Postgastrectomy
  • Deficiency or inactivation of pancreatic lipase
    • Exocrine pancreatic insufficiency
    • Chronic pancreatitis
    • Cystic fibrosis
    • Pancreatic insufficiency - congenital or acquired
  • Gastrinoma - acid inactivation of lipase
  • Lactose intolerance
Reduced intraduodenal bile acid concentration / impaired micelle formation


  • Liver disease
    • Parenchymal liver disease
    • Cholestatic liver disease
  • Bacterial overgrowth syndrome
    • Anatomic or functional stasis
  • Interrupted enterohepatic circulation of bile salts
  • Drugs (bind or precipitate bile salts) - calcium carbonate, neomycin, cholestyramine

Impaired mucosa absorption / mucosa loss or defect

  • Intestinal resection or bypass
  • Inflammation, infiltration, or infection
    • Celiac disease
    • Crohn's disease
    • Tropical sprue
    • Amyloidosis
    • Scleroderma
    • Lymphoma
    • Immuno proliferative small intestinal disease (IPSID)
    • Eosinophilic enteritis
    • Whipple's disease
    • Folate and Vitamin B12 deficiency
    • Infection - Giardiasis, Strongyloidiasis, Tuberculosis
    • Graft vs. host disease
  • Genetic disorders
    • Disaccharidase deficiency
    • Agammaglobulinemia
    • Abetalipoproteinemia
    • Hartnup disease
    • Cystinuria
Impaired nutrient delivery to and / or from intestine
Impaired nutrient delivery to and / or from intestine

Endocrine and metabolic disorders
Endocrine and metabolic disorders

  • Hyperthyroidism
  • Adrenal insufficiency
  • Diabetes mellitus
  • Hypoparathyroidism
  • Carcinoid syndrome
Q. What are the most frequent causes of malabsorption in children in India?
Causes
Infections - Giardiasis, Strongyloidiasis, Tuberculosis
Causes
Celiac sprue (Gluten sensitivity)
Causes
Lactose intolerance
Causes
Tropical sprue
Causes
Chronic pancreatitis
Causes
Lymphoma, Immunoproliferative small intestinal disease (IPSID)

 
 
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