pituitrin and Celiac-Disease

Topics: Biological Transport, Active; Celiac Disease; Cell Membrane Permeability; Diarrhea, Infantile; Gastric Juice; Humans; Intestinal Absorption; Intestines; Jejunum; Kinetics; Malabsorption Syndromes; Methods; Perfusion; Sodium; Vasopressins

A single case of gastric plasmacytoma showing unusual clinical and pathological features is described. The patient had gluten sensitive enteropathy, and showed increased circulating IgA levels prior to gastrectomy. Progression of the disease was associated with both K and L light chain proteinuria, hypoalbuminaemia, and vasopressin resistant polyuria. Pathological investigation revealed the coexistence of IgA secreting soft tissue plasmacytoma, with IgG secreting myeloma. The significance of these findings is discussed.

Topics: Autopsy; Blood Transfusion; Celiac Disease; Gastrectomy; Glutens; Humans; Immunoglobulin Fragments; Immunoglobulins; Kanamycin; Lymph Nodes; Male; Middle Aged; Multiple Myeloma; Osmolar Concentration; Plasmacytoma; Polyuria; Proteinuria; Serum Albumin; Sodium; Stomach; Stomach Neoplasms; Vasopressins

Topics: Adult; Animals; Body Fluids; Body Weight; Bromine; Cachexia; Celiac Disease; Child; Creatinine; Dogs; Emaciation; Extracellular Space; Female; Humans; Hypoproteinemia; Kwashiorkor; Lipid Metabolism; Male; Nutrition Disorders; Osmosis; Postgastrectomy Syndromes; Potassium Isotopes; Protein Biosynthesis; Proteins; Radioisotope Dilution Technique; Radioisotopes; Rats; Sodium; Sodium Isotopes; Thinness; Tritium; Vasopressins; Water-Electrolyte Balance

Water and electrolyte movement in the jejunum of normal subjects and patients with sprue was measured during perfusion with isotonic electrolyte solutions. Normal subjects absorbed water, sodium, and potassium. By contrast, in patients with sprue (seven with adult celiac sprue and one with tropical sprue) who had diarrhea and steatorrhea, these substances were secreted into the intestinal lumen. This indicates that the jejunal mucosa of these patients was in a secretory state with respect to water and electrolytes.A method is presented for detecting abnormalities in the effective pore size in disease states. The method is based on the principle of restrictive diffusion and involves measuring the simultaneous diffusion rates of solutes of different molecular size. Since the method does not depend on measurement of water flow in response to osmotic pressure gradients, it can be used in disease states in which absorption and secretory processes involving water may be abnormal.The ratio of urea to tritiated water diffusion in the jejunum of normal subjects averaged 0.8, compared to 0.2 in patients with sprue. This indicates a marked decrease in the effective pore size of the jejunal mucosa in sprue. This conclusion was strengthened by the finding that erythritol and L-xylose, which are somewhat larger solutes than urea, are essentially non-absorbable in small bowel involved with sprue.

Topics: Adult; Biological Transport; Biopsy; Celiac Disease; Diarrhea; Erythritol; Female; Humans; Intestinal Absorption; Intestinal Mucosa; Isotonic Solutions; Jejunum; Male; Middle Aged; Potassium; Sodium; Sprue, Tropical; Urea; Vasopressins; Water-Electrolyte Balance; Xylose

Topics: Celiac Disease; Diabetes Insipidus; Female; Humans; Infant; Pyelonephritis; Vasopressins