Clinicopathologic Analysis of Malabsorption Syndrome in a Tertiary Care Center in South India

Abstract

Background: Malabsorption syndrome is an umbrella term for manifestations consisting of diarrhea, steatorrhea, malnutrition, unexplained weight loss, persistent or recurrent abdominal pain, and anemia. Celiac disease and Tropical sprue remain the two important causes among many more. Materials and Methods: The objectives of this study were to assess the spectrum of histological features of malabsorption at a tertiary care center and to correlate the clinical, endoscopic, and histological features between the various etiologies. Biopsy specimens of 547 subjects formed the sample for this institutional-based, retrospective research. All subjects who had a clinical diagnosis of malabsorption and underwent subsequent endoscopic evaluation along with biopsy were considered. The hematoxylin and eosin-stained sections were analyzed for villous architecture and intraepithelial lymphocytes (IELs). The histopathological findings were further correlated with the endoscopic findings. Data thus obtained were statistically analyzed using Microsoft Excel for Windows (2010). Results: The mean age of the subjects was 46.65 ± 17.31 years and with 330 males (60.33%) and 217 female (39.63%) subjects. Chronic diarrhea was the major presenting symptom in 95% of the subjects (n = 520). Normal villous architecture was noted in 68.19%, while the remaining cases showed varying degrees of atrophy ranging from mild in 27.61% (n = 151) to moderate in 2.56% (n = 14) to severe in 1.65% (n = 9). IELs were noted in 70.78% of cases. Conclusion: Histopathological findings, when analyzed, showed intraepithelial lymphocytosis as the major diagnosis in 34.19% of cases (n = 187), followed by tropical sprue in 19.56% (n = 107) cases. The pathology was nonspecific in about 13.89% (n = 76).

Keywords

• celiac disease
• duodenal mucosa
• intraepithelial lymphocytes
• malabsorption syndrome
• tropical sprue