A foreigner living in Vietnam for one year, presented diarrhea, weight loss, malabsorption. Successfully with treatment of tropical sprue, he remains well and getting 8 kilograms in the first month.

1. CASE REPORT
CHRONIC DIARRHEA
MEDIC ENDOSCOPY UNIT

2. CLINICAL HISTORY
• MALE,53 YRS OLD, FOREIGN
• LOSE 13KGS/6MONTHS
• VOMITTING, DIARRHEA
• NO CHRONIC UNDERLYING DISEASE
• CACHEXIA, THIN
• TREATMENT FAILURE

3. RESULTS OF MAIN INVESTIGATIONS(FV)
• BLOOD GLUCOSE
• HIV(-)
• THYROID TESTS
• K 2.46
• ABD US , CT : NORMAL
• COLONOSCOPY: NORMAL
• STOOL TEST: NORMAL

4. PROVISIONAL DIAGNOSIS
• SEVERE CHRONIC DIARRHEA
• MALABSORPTION SYNDROME
• HYPOKALEMIA
• MEDIC : CAPSULE ENDOSCOPY

5. DUODENUM: NODULARITY LESIONS

6. ABNORMAL FLATTENING OF VILLI

7. ATROPHY OF FOLDS, MULTIPLE FISSURES

8. INFLAMMATION OF MUCOSA

9. ENDOSCOPIC DIAGNOSIS
• CELIAC SPRUE
• TROPICAL SPRUE
• NEED MORE SPECIFIC TESTS
• ANTI-tTG ANTIBODIES(-)
• DUODENAL BIOPSIES

10. FINAL DIAGNOSIS
• EXCLUSION OF CELIAC SPRUE
• TROPICAL SPRUE

11. TROPICAL SPRUE
• MALABSORPTION
• IN TROPICAL REGIONS
• CAUSE: NOT KNOWN
• ABNORMAL FLATTENING OF VILLI AND
INFLAMMATION
• TREATMENT: TETRACYCLINE+ FOLIC
ACID,VITAMIN B12

12. TREATMENT RESULT
• 2 WKS : STOP DIARRHEA
• GAIN WEIGHT, 8KGS/ 1 MONTH
• SUCCESSFUL TREATMENT
• FIRST CASE
• EXPERIENCE