D-xylose absorption in Ugandan patients with fever
Abstract
Description
A dissertation submitted in partial fulfillment of the requirements for the award of the degree of Master of Medicine in Medicine of Makerere University
Using 25gm oral dose D-xylose tolerance test was performed on 19 normal subjects and 24 subjects with fever. In the normal subjects, blood D-xylose levels showed a peak between one and two hours and then declined gradually to resting levels after five hours. The mean blood D-xylose levels were lower in the patients with fever and had a prolongation of absorption when compared to the controls. On the basis of both low 5-hour urine D-xylose and low blood levels at one hour after the oral dose a significant number (50%) of patients suffering from fever due to pulmonary tuberculosis and fever due to acute bacterial infection had evidence of D-xylose mal-absorption. In the probable absence of primary jejunal mucosal disease, the intestinal absorptive, disfunction has been attributed to systemic bacterial infection. The intestinal absorptive disfunction was also present in the two patients with chronic myeloid leukaemia. The effect of chronic myeloid leukaemia and myeleran on the jejunal mucosa is yet unknown and requires elucidation. The possible pathogenesis and consequences of this subclinical mal-absorption are discussed.
Using 25gm oral dose D-xylose tolerance test was performed on 19 normal subjects and 24 subjects with fever. In the normal subjects, blood D-xylose levels showed a peak between one and two hours and then declined gradually to resting levels after five hours. The mean blood D-xylose levels were lower in the patients with fever and had a prolongation of absorption when compared to the controls. On the basis of both low 5-hour urine D-xylose and low blood levels at one hour after the oral dose a significant number (50%) of patients suffering from fever due to pulmonary tuberculosis and fever due to acute bacterial infection had evidence of D-xylose mal-absorption. In the probable absence of primary jejunal mucosal disease, the intestinal absorptive, disfunction has been attributed to systemic bacterial infection. The intestinal absorptive disfunction was also present in the two patients with chronic myeloid leukaemia. The effect of chronic myeloid leukaemia and myeleran on the jejunal mucosa is yet unknown and requires elucidation. The possible pathogenesis and consequences of this subclinical mal-absorption are discussed.
Keywords
D-xylose absorption test, Intestinal malabsorption, Fever, Subclinical malabsorption Uganda