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L M Krums

Publications and source records attributed to L M Krums.

At least 19 recordsLinked to original sources
PubMed2006

[Celiac disease as a cause of iron deficiency anemia].

AIM: To examine incidence of celiac disease in patients with iron deficiency anemia (IDA) of unclear origin. MATERIAL AND METHODS: A total of 331 IDA patients were examined for celiac disease (CD). The diagnosis was made on the basis of histological findings upon examination of the biopsy of small intestinal mucosa, detection of antibodies to alpha-gliadine (AGA) and tissue transglutaminase (TTG). RESULTS: The cause of anemia was revealed in 270 (81.5%) of 331 patients. The rest 61 patients (18.4%) had anemia of unknown cause. A rise of AGA was detected in 33 (54.0%) of 61 patients, TTG--in 29 (47.5%) patients. CD was diagnosed in 29 (47.5%) patients. Four of 61 patients (6.5%) had no symptoms of malabsorption. CONCLUSION: All the patients with IDA of unclear genesis must undergo serological tests for CD. In high titers of antibodies to AGA and TTG, retrobulbar duodenal biopsy is indicated with histological study of small intestinal mucosa.

Adolescent↗
PubMed2004

[Prevalence of celiac disease in patients with chronic diarrhea].

The objective of this research was to study the frequency of celiac disease in patients with chronic diarrhea. The biopsy materials of the small intestine and levels of antibodies to alpha-gliadin of class A immunoglobulins (IgA) and tissue transglutaminase were studied in 206 patients with chronic diarrhea. Morphologic celiac-specific symptoms were discovered in 35 (16.9%) patients. Symptoms of the total atrophy were discovered in 28 patients (13.5%); those of subtotal one were found in 7 (3.4%) patients. The increase of antibody levels to IgA alpha-gliadin and tissue transglutaminase was discovered in all 35 patients. Their average level made up 123.7 21.2 units per milliliter and 48.7 11.3 units per milliliter, respectively. It was possible to observe the typical celiac form only in 4 (11.4%) patients; the latent form was found in 30 (85.7%) patients, and the torpid (refractory) form was discovered in 1 (2.8%) patient. The frequency of celiac disease in patients with chronic diarrhea is equal to 16.9%. Patients with the latent form of the disease prevail among patients with celiac disease. Immunological screenings with the subsequent morphologic study of the mucous coat of the small intestine should be prescribed to all patients with the chronic diarrhea syndrome to enable the early diagnostics of celiac disease.

Adolescent↗
PubMed2003

[Incidence of celiac disease in patients with chronic diarrhea].

AIM: To study prevalence of celiac disease (CD) among patients with chronic diarrhea (ChD). MATERIAL AND METHODS: Serum levels of IgA-antibodies to gliadin, endomysium, reticulin and tissue transglutaminase were examined in 206 patients with CD. Biopsies were obtained from a distal portion of the duodenum or a proximal portion of the jejunum. RESULTS: CD was diagnosed in 35 (16.9%) of 206 patients with ChD. The disease was typical in 5 (2.4%) patients and was latent in 30 (14.5%) patients. Antibodies to gliadin, endomysium, reticulin and tissues transglutaminase in diagnostically significant titers were detected in the serum of all the examinees with CD. Formation of the antitissue antibodies occurred because of destructive-dystrophic alterations of the connective tissue of the lamina propria mucosae pointing to the autoimmune nature of a pathological process in celiac disease. CONCLUSION: To diagnose CD in ChD patients, it is necessary to supplement standard examination with duodenobiopsy, tests for antibodies to gliadin, tissue transglutaminase and to tissue structures--endomysium and reticulin.

Adolescent↗
PubMed2002

[Diagnosis of gluten enteropathy and efficiency of its treatment].

AIM: To develop screening diagnosis of gluten enteropathy (GEP), indications to administration of glucocorticoid hormones and objective criteria of effective treatment. MATERIAL AND METHODS: Clinical, immunological (antibodies-Abs to alpha-gliadin, reticulin and endomisium) examinations, enterobiopsy with morpho- and stereometry of small intestinal mucosa were made in 200 GEP patients. The examination was repeated 6 months to 5 years and later after the discharge from the hospital. RESULTS: Mean values of Abs to alpha-gliadin was 6 times higher than normal values. Positive titers of Abs to endomisium and reticulin were in 100 and 87.5% patients, respectively. Formed stool was registered 1.5 times more frequently, polyfecalia occurred 2.5 times less frequently, hypovitaminosis and trophic disorders were relieved 3 times more frequently, malabsorption syndrome reduced in patients given prednisolone vs those untreated with it. CONCLUSION: Screening diagnosis of GEP may be based on Abs tests to alpha-gliadin, reticulin and endomisium. Improvement of clinical condition of GEP patients can be stated by decreased diarrhea, polyfecalia and malabsorption symptoms. The treatment efficacy may be judged by clinical improvement, recovery of morphological structure of small intestinal mucosa, normalization of concentration of Abs to alpha-gliadin, reticulin, endomisium. Administration of prednisolone provides more complete and rapid rehabilitation of the patients.

Adult↗
PubMed2002

[Chronic diarrhea: pathogenesis and therapy].

Periodical diarrhea is one of the steadiest symptoms of chronic bowels diseases. This term defines an increase of stool frequency (over three times a day) with the excretion of greater amount and more liquid consistency of excrements as compared to usual bowels emptying of the given individual. Diarrhea is considered to be chronic if its duration is over 30 days. Pathogenetic mechanisms of formation and development of chronic diarrheas have a lot in common. As a result, any diarrhea is a clinical manifestation of a disorder of water and electrolytes transportation in the digestive tract. Such disorders appear due to indigestion, absorption and secretion disorders. At that the small intestine and large intestine should be considered as a single physiological unit.

Bacteria↗
PubMed2002

[General variable hypogammaglobulinemia].

The purpose of the paper was studying the features of course and treatment of common variable hypogammaglobulinemia (CVHG), proceeding with intestinal function disorders functions.

Antibody Formation↗
PubMed1992

[Gluten enteropathy].

The authors relate the results of 10 years of observations of 113 patients suffering from gluten enteropathy (GE) of the adults. In all the patients, the diagnosis was supported by the presence of hyper-regenerative atrophy of the small intestinal mucosa (total in 70% and subtotal in 30%). Metabolic disorders and cellular immunity were investigated. At the onset of the observations 70.7% of the patients demonstrated malabsorption, stage III gravity, and 29.3% stage II. It has been proved that permanent and strict adherence to the agluten diet and administration of corticosteroids in the most severe cases in combination with pathogenetic therapy of diarrhea and metabolic disorders permit attaining a steady clinical remission, improvement of normalization of the biochemical and immunological characteristics, a tendency toward normalization of the small intestinal mucosa, and even the recovery of its normal structure in part of the cases.

Adolescent↗
PubMed1991

[Treatment of chronic diseases of the small intestine].

Multimodality and differentiated treatment of small-intestinal diseases is to combine methods of etiological action with pathogenetic treatment of the main clinical syndromes: chronic diarrhea, malabsorption syndrome, hypercatabolic exudative enteropathy. Each nosological form should be treated specifically. Pathogenetic treatment involves diet therapy, chemotherapeutic correction of metabolic processes (vitamin administration, recovery of normal protein and lipid metabolism, water and electrolyte balance, anemia), management of chronic diarrhea. Treatment regimens are specified for gluten enteropathies, total variable immunodeficiency, Whipple disease, small-intestinal diverticulosis, Crohn's disease, amyloidoses, intestinal lymphoma and retroperitoneal lymph nodes. Clinical experience justifies the above methods as highly effective.

Chronic Disease↗
PubMed1991

[Mechanisms of the development of the chronic phase of diseases of the small intestine].

The results of studying mechanisms underlying chronicity of functional (chronic enteritis ) and severe organic (celiac disease) lesions of the small intestine have been analyzed. Mechanisms causing the diseases take a chronic course appeared very similar. They involve bacterial proliferation in the intestine with consequent impairment of the digestion, absorption and motility resultant in derangement of metabolism. Defects in protein and lipid metabolism proved most essential. Chronic enteritis is associated with a favorable outcome provided there are no grave malabsorption symptoms. Combined treatment as a rule produces good therapeutic response in chronic enteritis and celiac disease. Relevant schemes are presented.

Amino Acids↗
PubMed1991

[Current problems in the diagnosis and treatment of small intestinal diseases].

Based on the data obtained during clinical examination of 1,026 patients with small intestinal diseases the authors provide the portion of laboratory and instrumental methods employed in the diagnosis of different disease entities. The clinical picture of small intestinal diseases is mainly determined by the gravity of malabsorption. Histological examination of the small intestinal mucosa is a method of choice in the diagnosis of gluten enteropathy, Whipple's disease, primary lymphangiectasis and amyloidosis. Immunoassays play the key role in recognition of variable immunodeficiencies and disease of heavy alpha-chains. Meanwhile in differential diagnosis of Crohn's disease, small intestinal tumors, congenital abnormalities of rotation and in some others, the leading part is played by x-ray methods. The authors describe the treatment schedule based on the pathogenetic approach, that makes it possible to reach a stable clinical remission and recovery of the working capacity even in part of patients with stage III malabsorption.

Diagnosis, Differential↗
PubMed1990

[Disorders of lipid metabolism in patients with chronic diseases of the small intestine].

Lipid metabolism was evaluated in patients with chronic enteritis, celiac disease, general variable immunodeficiency (GVI), short-bowel syndrome. In chronic enteritis with malabsorption syndrome degree I and II changes in metabolism were characterized by hyperlipidemia due to high lipid fractions, mainly triglycerides; in malabsorption syndrome degree III (celiac disease, general variable immunodeficiency, short-bowel syndrome) by a drop of serum total lipids, phospholipids, cholesterol, beta-lipoproteins, free fatty acids, elevated concentrations of triglycerides. Changes in fatty acid composition of blood serum in patients with malabsorption syndrome degree III manifested by derangement of polyunsaturated fatty acids ratio. Arachidonic acid concentration was reduced in 100% of cases, linolenic acid in 45%. In all the patients with celiac disease and malabsorption syndrome degree III there was hypoactivity of lipolytic blood enzymes lipase and tributyrinase.

Celiac Disease↗